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DOI: http://dx.doi.org/10.21088/ijog.2321.1636.5217.19

Abstract

Background: Transvaginal ultrasound is a noninvasive diagnostic tool commonly used to evaluate women with postmenopausal uterine bleeding. The ultrasound examination for endometrial pathology includes a measurement of endometrial thickness. In clinical studies, endometrial malignancy is uncommon in women with an endometrial thickness measurement <5 mm. Aim: To evaluate transvaginalultrasonographic measurement of endometrial thickness as a valid biomarker of oestrogen exposure by correlating with serum oestrogen levels and to validate its assessment in diagnosing endometrial cancer in comparison with biopsy. Materials and Methods: A crosssectional study was conducted for a period of one year among women in age group of 40 – 70 years attending the gynaecology OPD in our hospital with the complaints of postmenopausal bleeding. Total of 250 women were included in the study. Basic blood and biochemical tests were performed and serum estradiol levels were measured for all women in the study population. Transvaginal ultrasound was performed on all patients by using a 7.5 MHz transvaginal sector probe with phased array and end firing potential. Results: A perfect positive correlation exists between the endometrial thickness and the serum oestrogen levels (r = 0.62). The sensitivity (100%), specificity (98.6%) positive predictive value (94.1%) and negative predictive value (100%) for endometrial thickness in detecting cancer endometrium was found to be very high which would suggest that assessment of endometrial thickness through transvaginal ultrasound is an effective screening test in the detection of endometrial carcinoma. Conclusion: Though endometrial thickness can be used as an initial screening test in detection of endometrial malignancies but the high rates of false negatives might warn us in using it alone without a endometrial biopsy. Still many multicentric studies are warranted to substantiate our findings and to set a cutoff level of endometrial thickness in diagnosing carcinoma.

Keywords: Endometrial Thickness; Transvaginal Ultrasound; Serum Oestrogen; Biopsy; Endometrial Carcinoma. 

Corresponding Author : Shankar Radhakrishnan, Associate Professor, Department of Preventive Medicine, Vinayaka Mission Kirupanandavariyar, Medical College and Hospital, Salem, Tamil Nadu 636308, India.