The accuracy of endometrial Pipelle sampling with and without sonographic measurement of endometrial thickness.
OBJECTIVE
To evaluate the accuracy of Pipelle endometrial sampling with and without sonographic measurement of endometrial thickness.


METHODS
We studied prospectively 176 consecutive patients (23% after and 77% before menopause) scheduled for D&C. Sonographic measurement of the endometrium and endometrial biopsy with the Pipelle were performed before the curettage.


RESULTS
In 159 cases (90%), the endometrial histologic results of curettage agreed with those of the Pipelle biopsy. All three cases of endometrial cancer were identified by Pipelle aspiration. In seven cases (4%), the Pipelle aspiration failed to detect hyperplasia. Sonographic endometrial thickness of more than 5 mm slightly increased the sensitivity and slightly decreased the specificity of Pipelle aspiration from 82 to 92% and from 99 to 96%, respectively. In postmenopausal patients admitted for bleeding, the sensitivity and specificity reached 100%.


CONCLUSIONS
Our data suggest that normal Pipelle aspirates in premenopausal patients with abnormal uterine bleeding are highly accurate. In postmenopausal patients with sonographic endometrial thickness of 5 mm or less, the accuracy reached 100%.
Goldchmit
R
R
Department of Obstetrics and Gynecology, Kaplan Hospital, Rehovot, Israel.
Katz
Z
Z
Blickstein
I
I
Caspi
B
B
Dgani
R
R
D000328:Adult; D000368:Aged; D001706:Biopsy / Q000295:instrumentation*; D004714:Endometrial Hyperplasia / Q000000981:diagnostic imaging* / Q000473:pathology*; D004717:Endometrium / Q000000981:diagnostic imaging* / Q000473:pathology*; D005260:Female; D006801:Humans; D008593:Menopause; D008875:Middle Aged; D011237:Predictive Value of Tests; D011446:Prospective Studies; D012680:Sensitivity and Specificity; D014463:Ultrasonography