title: Endometrial Evaluation in Asymptomatic Postmenopausal Women by Transvaginal Sonography and Color Flow Doppler
abstract: We attempted to correlate transvaginal ultrasound endometrial assessment with histologic and hysteroscopic findings in 910 asymptomatic postmenopausal women. The women all had been postmenopausal for at least 1 year, and had no sonographically documented adnexal masses, no hormone therapy, and no history of uterine bleeding. Endometrial thickness of 5 mm and less was considered normal, and no further investigations were performed. All women with endometrial thickness 8 mm or greater were advised to undergo hysteroscopy and endometrial biopsy if necessary. When endometrial thickness was 6 to 7 mm, hysteroscopy was recommended if irregular endometrial echotexture was observed; otherwise another ultrasound examination within 3 to 6 months was suggested. We observed 83 (9.1%) asymptomatic women with endometrial thickness 8 mm or greater and 77 (8.5%) with a thickness of 6 to 7 mm, in whom a total of 89 hysteroscopies were performed. Three endometrial cancers, 8 hyperplasias, 27 endometrial polyps, and 5 submucosal myomas were detected in those with endometrial thickness of 8 mm or greater. Of the 21 women with endometrial thickness 6 to 7 mm who underwent hysteroscopy, 7 had endometrial polyps, 4 hyperplasia, and 3 submucosal myomas. Based on sensitivity and specificity analyses, an endometrial thickness of 8 or 10 mm in asymptomatic postmenopausal women seems to be an effective cut-off to select candidates for more invasive diagnostic procedures.
authors.affiliation: Department of Obstetrics and Gynecology, University of "Tor Vergata," Policlinico S. Eugenio - Viale Umanesimo 10, 00144 Rome, Italy.
authors.initials: C
authors.lastname: Exacoustos
authors.initials: M
authors.lastname: Chiaretti
authors.initials: MC
authors.lastname: Minghetti
authors.initials: L
authors.lastname: Bianchi
authors.initials: D
authors.lastname: Arduini
authors.initials: C
authors.lastname: Romanini