HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

This Article Figures Only Full Text Full Text (PDF) Submit a response Alert me when this article is cited Alert me when eLetters are posted Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Dubinsky, T. J. Articles by Maklad, N. Search for Related Content PubMed PubMed Citation Articles by Dubinsky, T. J. Articles by Maklad, N.

Prediction of Benign and Malignant Endometrial Disease: Hysterosonographic-Pathologic Correlation

¹ Department of Radiology, University of Washington, Harborview Medical Center, Box 728359, 325 Ninth Ave, Seattle, WA 98104 (T.J.D.)
² Departments of Pathology (K.S.)
³ Radiology, Obstetrics, Gynecology, and Reproductive Health Sciences (N.M.), University of Texas, Houston
⁴ Department of Radiology, Amman Hospital, Jordan (Y.A.G.)
⁵ Department of Radiology, Veterans Affairs Medical Center, St Louis, Mo (H.R.P.).

PURPOSE: To determine the transvaginal hysterosonographic appearances of benign and malignant endometrial disease.

MATERIALS AND METHODS: From April 11, 1994, through August 1, 1996, a total of 88 women (age range, 25–81 years) underwent transvaginal hysterosonography and histopathologic evaluation of the endometrium after dilation and curettage or after hysterectomy. A benign appearance at transvaginal hysterosonography was defined as a thin endometrium, diffuse smooth endometrial thickening, or a smoothly marginated, homogeneously echogenic, pedunculated endoluminal mass. A suspicious appearance was defined as either irregular thickening of the endometrium or an inhomogeneous endoluminal mass.

RESULTS: Of 88 women, 37 had a benign-appearing endometrium at transvaginal hysterosonography; at histologic examination, 16 had a proliferative endometrium, 12 had a secretory endometrium, six had polyps, two had an inactive endometrium, and one had carcinoma. Of the 51 women with suspicious endometrial appearances, eight had carcinoma, 24 had adenomatous polyps, five had hyperplasia, 11 had fibroids, and three had endometritis. For carcinoma, the sensitivity of transvaginal hysterosonography was 89%, specificity was 46%, positive predictive value was 16%, and negative predictive value was 97%.

CONCLUSION: A thin endometrium or diffuse smooth endometrial thickening is predictive of benign endometrial histologic findings, but all women with endoluminal masses require further histologic evaluation to exclude malignant disease.

Index terms: Genitourinary system, US, 854.12989 • Uterine neoplasms, 854.30 • Uterine neoplasms, US, 854.12989 • Uterus, endometrium, 854.30

This article has been cited by other articles:

				AIUM Practice Guideline for Ultrasonography in Reproductive Medicine J. Ultrasound Med., January 1, 2009; 28(1): 128 - 137. [Full Text] [PDF]

				G Michail, A Karahaliou, S Skiadopoulos, C Kalogeropoulou, G Terzis, I Boniatis, L Costaridou, G Kourounis, and G Panayiotakis Texture analysis of perimenopausal and post-menopausal endometrial tissue in grayscale transvaginal ultrasonography Br. J. Radiol., August 1, 2007; 80(956): 609 - 616. [Abstract] [Full Text] [PDF]

				D. L. Berridge and T. C. Winter Saline Infusion Sonohysterography: Technique, Indications, and Imaging Findings J. Ultrasound Med., January 1, 2004; 23(1): 97 - 112. [Abstract] [Full Text] [PDF]

				L. E. Hann, C. M. Kim, M. Gonen, R. Barakat, P. H. Choi, and A. M. Bach Sonohysterography Compared With Endometrial Biopsy for Evaluation of the Endometrium in Tamoxifen-Treated Women J. Ultrasound Med., November 1, 2003; 22(11): 1173 - 1179. [Abstract] [Full Text] [PDF]

				E. Becker Jr, A. S. Lev-Toaff, E. P. Kaufman, E. J. Halpern, M. I. Edelweiss, and A. B. Kurtz The Added Value of Transvaginal Sonohysterography Over Transvaginal Sonography Alone in Women With Known or Suspected Leiomyoma J. Ultrasound Med., March 1, 2002; 21(3): 237 - 247. [Abstract] [Full Text] [PDF]

				S. Laifer-Narin, N. Ragavendra, E. K. Parmenter, and E. G. Grant False-Normal Appearance of the Endometrium on Conventional Transvaginal Sonography: Comparison with Saline Hysterosonography Am. J. Roentgenol., January 1, 2002; 178(1): 129 - 133. [Abstract] [Full Text] [PDF]

				T. J. Dubinsky, S. Reed, C. Mao, G. M. Waitches, and E. K. Hoffer Hysterosonographically Guided Endometrial Biopsy: Technical Feasibility Am. J. Roentgenol., June 1, 2000; 174(6): 1589 - 1591. [Full Text]

				J. R. Medverd and T. J. Dubinsky Cost Analysis Model: US versus Endometrial Biopsy in Evaluation of Peri- and Postmenopausal Abnormal Vaginal Bleeding Radiology, March 1, 2002; 222(3): 619 - 627. [Abstract] [Full Text] [PDF]