title: Ultrasound examination of the endometrium before and after Pipelle endometrial sampling.
abstract: OBJECTIVE
  To evaluate if, and to what extent, Pipelle de Cornier endometrial sampling influences the ultrasonographic features of the endometrium.
  
  
  METHODS
  This was a prospective descriptive study on 99 consecutive women in whom a Pipelle endometrial biopsy was performed. All patients first underwent a transvaginal ultrasound evaluation of the uterus. The endometrial thickness (ET) was measured and endometrial sonographic features were recorded. Thereafter, a Pipelle endometrial biopsy was taken. Finally, the ultrasound examination was repeated. The patients' characteristics, the sampling procedure, the endometrial histology and the sonographic findings before and after Pipelle biopsy were compared.
  
  
  RESULTS
  Ninety-nine women, of whom 45% were postmenopausal, entered the study. The mean age was 59.0 years (SD, 9.9) for the postmenopausal women, and 41.6 years (SD, 8.7) for the rest. On histological examination, endometrial cancer was diagnosed in four patients and endometrial hyperplasia in eight patients. The average ET before Pipelle sampling was 9.0 mm (SD, 6.6) vs. 8.6 mm (SD, 7.0) after biopsy (P < 0.0001). After Pipelle sampling, the endometrium was less clearly delineated (P = 0.03) and more echogenic endometrial spots were seen (P < 0.0001). If an endometrial three-layer pattern was noted before sampling, it was not observed in most women after Pipelle biopsy (P = 0.0003).
  
  
  CONCLUSIONS
  ET measurements are affected by Pipelle sampling and the quality of the ultrasound features tends to be altered by biopsy. Performing the ultrasound examination before proceeding with endometrial sampling may therefore improve diagnostic accuracy of ultrasound.
authors.affiliation: Department of Obstetrics and Gynecology, A. Z. Heilig Hart, Tienen, Belgium. thierry.van.den.bosch@skynet.be
authors.forename: T
authors.initials: T
authors.lastname: Van den Bosch
authors.forename: D
authors.initials: D
authors.lastname: Van Schoubroeck
authors.forename: L
authors.initials: L
authors.lastname: Ameye
authors.forename: S
authors.initials: S
authors.lastname: Van Huffel
authors.forename: D
authors.initials: D
authors.lastname: Timmerman
mesh_terms: D000328:Adult; D000368:Aged; D001706:Biopsy / Q000379:methods; D004717:Endometrium / Q000000981:diagnostic imaging* / Q000473:pathology; D005260:Female; D006801:Humans; D008875:Middle Aged; D011446:Prospective Studies; D014463:Ultrasonography; D014591:Uterine Diseases / Q000000981:diagnostic imaging* / Q000473:pathology; D014592:Uterine Hemorrhage / Q000000981:diagnostic imaging / Q000473:pathology