Speciality
Spotlight

 




 

Obstetric & Gynaecology

 

 




Sonography

 
  

  • A C Fleischer, J E Wheeler, et al (Nashville, Tennessee, Philadelphia and Collegeville, Pennsylvania, Detroit, Michigan, and London, United Kingdom.

    An assessment of the value of ultrasonographic screening for endometrial disease in postmenopausal women without symptoms.

    Am J Obstet Gynecol, Jan 2001; 184: 70-74

       

    Objective: To evaluate the use of transvaginal ultrasonography for the detection of endometrial disease in a population of postmenopausal women who were without symptoms.

      

    Study Design: Postmenopausal women were screened for potential inclusion in 2 multicenter, double-blind, placebo-controlled studies of 2 years’ duration to evaluate the safety and efficacy of idoxifene in the prevention of osteoporosis. Baseline endometrial evaluation was performed by transvaginal ultrasonography and aspiration biopsy of the
    endometrium.

      

    Results: A total of 1926 women were screened by transvaginal ultrasonography, and 1833 of them had endometrial thickness £6mm. Five cases of endometrial abnormality (adenocarcinoma (n=1) and atypical hyperplasia (n=4) were detected in the 1750 women from this cohort who underwent biopsy. The negative predictive value was >99%. One case of adenocarcinoma was detected in the 42 women who had endometrial trial thickness >6mm and underwent biopsy. However, the sampling rate (45%) of women with endometrial thickness >6mm was too low for confidence in the positive predictive value of 2%.

      

    Comment: This is the largest comparison of transvaginal ultrasonography and endometrial biopsy yet reported and indicates that in untreated postmenopausal women without symptoms the prevalence of endometrial abnormality is <1%. Therefore the use of a 6-mm threshold for endometrial thickness has very high specificity and negative predictive value because the vast majority of women in this population have atrophic
    endometrium.

      

    In contrast to the data in women without symptoms, transvaginal ultrasonography has a high positive predictive value for the presence of endometrial abnormality in women with postmenopausal bleeding.

     

    Conclusions: Despite a high negative predictive value, transvaginal ultrasonography may not be an effective screening procedure for detection of endometrial abnormality in untreated postmenopausal women who are without symptoms.

       

      



 

 

Speciality Spotlight

 

 

Sonography
 
  

  • A C Fleischer, J E Wheeler, et al (Nashville, Tennessee, Philadelphia and Collegeville, Pennsylvania, Detroit, Michigan, and London, United Kingdom.
    An assessment of the value of ultrasonographic screening for endometrial disease in postmenopausal women without symptoms.
    Am J Obstet Gynecol, Jan 2001; 184: 70-74
       
    Objective: To evaluate the use of transvaginal ultrasonography for the detection of endometrial disease in a population of postmenopausal women who were without symptoms.
      
    Study Design: Postmenopausal women were screened for potential inclusion in 2 multicenter, double-blind, placebo-controlled studies of 2 years’ duration to evaluate the safety and efficacy of idoxifene in the prevention of osteoporosis. Baseline endometrial evaluation was performed by transvaginal ultrasonography and aspiration biopsy of the endometrium.
      
    Results: A total of 1926 women were screened by transvaginal ultrasonography, and 1833 of them had endometrial thickness £6mm. Five cases of endometrial abnormality (adenocarcinoma (n=1) and atypical hyperplasia (n=4) were detected in the 1750 women from this cohort who underwent biopsy. The negative predictive value was >99%. One case of adenocarcinoma was detected in the 42 women who had endometrial trial thickness >6mm and underwent biopsy. However, the sampling rate (45%) of women with endometrial thickness >6mm was too low for confidence in the positive predictive value of 2%.
      
    Comment: This is the largest comparison of transvaginal ultrasonography and endometrial biopsy yet reported and indicates that in untreated postmenopausal women without symptoms the prevalence of endometrial abnormality is <1%. Therefore the use of a 6-mm threshold for endometrial thickness has very high specificity and negative predictive value because the vast majority of women in this population have atrophic endometrium.
      
    In contrast to the data in women without symptoms, transvaginal ultrasonography has a high positive predictive value for the presence of endometrial abnormality in women with postmenopausal bleeding.
     
    Conclusions: Despite a high negative predictive value, transvaginal ultrasonography may not be an effective screening procedure for detection of endometrial abnormality in untreated postmenopausal women who are without symptoms.
       

      

 

By |2022-07-20T16:43:16+00:00July 20, 2022|Uncategorized|Comments Off on Sonography

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