This paper is only available as a PDF. To read, Please Download here.
Diagnostic curettage has for many years been the method of choice to diagnose endometrial
cancer in women with postmenopausal bleeding. The costs for curettage performed today
are huge, and approximately only 10% in this group of women will be diagnosed with
endometrial cancer. Thus less expansive techniques to obtain endometrial samples have
been evaluated, but all of them are invasive. The value of endovaginal ultrasonography
for identifying endometrial abnormality in this group of women has not been evaluated
until now. This study used endometrial thickness as measured by endovaginal ultrasonography
as an indicator of endometrial abnormality. It was demonstrated in 205 women with
postmenopausal bleeding that if the endometrium was <9 mm thick, no endometrial cancer
was found at curettage. The mean endometrial thickness in those women with endometrial
cancer was 18.2 ± 6.2 mm as compared with 3.4 ± 1.2 mm in those women with atrophic
endometrium. If the cutoff limit for endometrial abnormality was 5 mm, the positive
predictive value for identifying endometrial abnormality was 87.3%. If this limit
had been used in this study, 70% of the curettage procedures could have been avoided.
Key words
To read this article in full you will need to make a payment
Purchase one-time access:
Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online accessOne-time access price info
- For academic or personal research use, select 'Academic and Personal'
- For corporate R&D use, select 'Corporate R&D Professionals'
Subscribe:
Subscribe to American Journal of Obstetrics & GynecologyAlready a print subscriber? Claim online access
Already an online subscriber? Sign in
Register: Create an account
Institutional Access: Sign in to ScienceDirect
References
- Diagnostic dilatation and curettage: a reappraisal.Am J Obstet Gynecol. 1982; 142: 1-6
- Critical assessment of dilatation and curettage in 1029 women.Lancet. 1978; 2: 566-568
- Endometrial findings following curettage in 2018 women according to age and indications.Ann Chir Gynaecol. 1983; 72: 274-277
- Endometrial sampling prior to hysterectomy.Obstet Gynecol. 1989; 73: 405-409
- Prehysterectomy curettage.Obstet Gynecol. 1975; 45: 537-541
- The fallacy of simple uterine curettage.Obstet Gynecol. 1958; 12: 642-647
- Sonographic depiction of the endometrium during normal cycles.Ultrasound Med Biol. 1986; 12: 271-275
- Transvaginal sonography of the endometrium during ovum pickup in stimulated cycles for in vitro fertilization.J Ultrasound Med. 1989; 8: 549-553
- Sonographic depiction of normal and abnormal endometrium with histopathologic correlation.J Ultrasound Med. 1986; 5: 445-452
- Transvaginal and transabdominal sonography: prospective comparison.Radiology. 1988; 168: 639-643
- Preoperative sonographic evaluation of endometrial cancer.Am J Obstet Gynecol. 1989; 160: 133-137
- Vaginal endosonography in endometrial cancer.Lancet. 1989; 1: 445-446
- Ultrasonic assessment of endometrial cancer invasion.JCU. 1987; 15: 519-524
- Ultrasonic evaluation of endometrial cancer. Euroson, Helsinki1987: 187
- Intrauterine ultrasonography and endometrial cancer.Lancet. 1989; 2: 842-843
- Sonographic depiction of endometrial changes occurring with ovulation induction.J Ultrasound Med. 1984; 3: 341-346
- Correlation of ultrasound findings and endometrial histopathology in postmenopausal women.Br J Obstet Gynaecol. 1989; 96: 133-138
- Transvaginal and transabdominal sonography of the endometrium.Semin Ultrasound Comput Tomogr Magnet Res. 1988; 9: 81-101
- Ultrasound diagnosis of small asymptomatic bladder carcinoma in patients referred for gynecological scan.J Urol. 1984; 132: 892-893
- The cancer registery: cancer incidence in Sweden 1985. National Board of Health and Wellfare, Stockholm1989: 60
Article Info
Publication History
Accepted:
August 20,
1990
Received in revised form:
June 18,
1990
Received:
March 6,
1990
Footnotes
†This study was supported by grants from Brüel & Kjaer AS, Naerum, Denmark, and from The King Gustav V Jubilee Clinical Cancer Research Foundation, the Göteborg Medical Society, and the Assar Gabrielsson Foundation, Göteborg.
Identification
Copyright
© 1991 Mosby. Published by Elsevier Inc. All rights reserved.
