The Validity of Transvaginal Sonography in the Measurement of Endometrial Thickness

Background and Objective: Transvaginal ultrasonography is a non invasive procedure for endometrial thickness evaluation in abnormal uterine bleeding. This technique is helpful for selecting patients for diagnostic tests. This study was designed to determine the validity of transvaginal sonography in the measurement of endometrial thickness. Materials and Methods: A total of ۷۱ women who were admitted for abdominal hysterectomy due to different causes in Kosar Hospital (۲۰۰۸–۲۰۰۹) were enrolled in the study. The main exclusion criteria was inability to measure endometrial thickness via transvaginal sonography. Endometrial thickness measurements were done prior to surgery. Histopathologic measurement of the fresh specimen was carried out immediately after surgery. Data were analyzed using T-test and kappa index. Results: No ultrasound measurement was possible in ۱۵% (۱۱) of the patients. No statistically significant difference was observed in endometrial thickness between the two procedures. Taking into account ۵ mm as a cut– off point, in ۷۰% (۴۲) of the patients, endometrial thickness was > ۵ mm in both procedures. In ۳۰% (۱۸) of the patients, endometrial thickness in sonography was >۵ mm, ۱۱ cases of which were confirmed by histopathologic measurement. The remaining ۷ cases were falsely reported as thick endometrium by sonography. The overall accuracy of sonography was about ۸۳/۳%, which was more efficient for samples with thin endometrium (۸۹/۸% vs. ۷۲/۸%). Conclusion: Despite a concordance between transvaginal sonography and histopathology results for endometrial thickness evaluation, the former is faced with limitation as a single diagnostic test.

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Keywords: Endometrial thickness ، Transvaginal ultrasound ، Abnormal uterine bleeding