title: Diagnostic accuracy of endometrial thickness to exclude polyps in women with postmenopausal bleeding.
abstract: OBJECTIVE
  To determine the accuracy of endometrial thickness measurement with transvaginal ultrasonography (TVUS) to diagnose endometrial polyps in women with postmenopausal bleeding in whom a carcinoma has been ruled out.
  
  
  METHODS
  In women with postmenopausal bleeding, endometrial thickness was measured with TVUS. If endometrial thickness was >4 mm, office hysteroscopy was performed. At hysteroscopy, the uterine cavity was assessed for the presence of polyps. Patients with malignancy were excluded. We used receiver operating characteristics (ROC) analysis to assess the capacity of TVUS endometrial thickness measurement to diagnose endometrial polyps. Findings at hysteroscopy were considered to be the reference standard.
  
  
  RESULTS
  We included 178 patients with postmenopausal bleeding and endometrial thickness >4 mm. Hysteroscopy showed an endometrial polyp in 90 patients (50%). The ROC analysis revealed that endometrial thickness had an area under the curve of 0.64 in the diagnosis of endometrial polyps.
  
  
  CONCLUSIONS
  In women with postmenopausal bleeding in whom carcinoma has been ruled out, measurement of endometrial thickness with TVUS is not useful in the diagnosis of endometrial polyps.
authors.affiliation: Department of Perinatology and Gynecology, University Medical Centre Utrecht, 3508 AB Utrecht, POB 85090, The Netherlands.
authors.forename: Anne
authors.initials: A
authors.lastname: Timmermans
authors.forename: Maaike B E
authors.initials: MB
authors.lastname: Gerritse
authors.forename: Brent C
authors.initials: BC
authors.lastname: Opmeer
authors.forename: Frank W
authors.initials: FW
authors.lastname: Jansen
authors.forename: Ben W J
authors.initials: BW
authors.lastname: Mol
authors.forename: Sebastiaan
authors.initials: S
authors.lastname: Veersema
mesh_terms: D003937:Diagnosis, Differential; D004717:Endometrium / Q000000981:diagnostic imaging*; D019160:Endosonography / Q000379:methods*; D005260:Female; D006801:Humans; D015907:Hysteroscopy / Q000379:methods; D011127:Polyps / Q000150:complications / Q000175:diagnosis*; D017698:Postmenopause; D012372:ROC Curve; D014592:Uterine Hemorrhage / Q000000981:diagnostic imaging* / Q000209:etiology; D014594:Uterine Neoplasms / Q000150:complications / Q000175:diagnosis*