Department of Radiology, Samsung Cheil Hospital, Sungkyunkwan University School of Medicine.
Published online: January 1, 2001.
ABSTRACT
PURPOSE: To determine whether the transvaginal sonographic appearance of the thickened endometrium can help to predict the underlying endometrial pathologic process. MATERIALS and METHODS: The sonogram reports of all 41 pre-and 21 postmenopausal women who underwent transvaginal sonogram were retrospectively analyzed. The women undergoing estrogen replacement therapy, tamoxifen therapy or having abnormal cervical cytology were excluded from this study. The analysis of sonographic and histologic results was performed in all patients. RESULTS: Three distinct sonographic patterns were encountered. Type I consisted of heterogeneous endometrial thickening with internal hypoechoic areas (normal[n=4], polyp[n=1] and cancer[n=4] in premenopausal women and cancer[n=4] in postmenopasual women). Type II consisted of echogenic endometrial thickening with or without tiny cysts (normal[n=5], & hyperplasia[n=7] in premenopasual women and normal[n=4], polyp[n=2], & hyperplasia[n=1] in postmenopausal women). Type III consisted of localized well defined endoluminal lesion (normal[n=1], polyp[n=14], hyperplasia[n=1], cancer[n=1], & submucosal mass[n=3] in premenopausal women and normal[n=4], polyp[n=2], submucosal mass[n=3], & hematoma[n=1] in postmenopausal women). CONCLUSION: The measurement of the endometrial thickness combined with analysis of sonographic echopatterns may be helpful in prediction and differentiation of endometrial disease in pre- and postmenopausal women. Also it can contribute to avoiding unnecessory D&C.
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