绝经后阴道出血患者诊断性刮宫前B超检测子宫内膜的价值

Diagnostic Value of Endometrial Assessment by Transvaginal Ultrasonography in Patients with Postmenopausal Bleeding

目的：评估绝经后阴道出血患者应用Ｂ超检测子宫内膜，以减少不必要的诊断性刮宫术（诊刮术）的价值。方法：对１９２例绝经后阴道出血患者，于诊刮术前行Ｂ超检查，测量子宫大小及子宫内膜厚度，然后进行分段诊刮术，标本送病理检查。结果：７７例内膜厚度≤４ｍｍ者中，７４例（９６．１％）子宫内膜属生理性改变，３例为内膜癌；１１５例子宫内膜厚度≥５ｍｍ者中，９２例（８０．０％）子宫内膜属病理性改变，其中５９例（５１．３％）为内膜癌。结论：高分辨阴道Ｂ超检测，可作为绝经后出血患者进行诊刮术前的一种筛选手段，当超声检测内膜厚度≤４ｍｍ时，可考虑避免诊刮术。

Objective: To assess the value of endometrial transvaginal sonography in diagnosis of patients with postmenopausal bleeding. Methods: High resolution transvaginal ultrasonographic examination was performed in 192 patients with postmenopausal bleeding before fractional uterine curettage. The results of endometrial sonogram were compared with endometrial histological findings.Results: Seventy seven cases had endometrial thickness≤4mm. 74 of them (96.1%) showed physiological changes by pathological examination. Only 3 were endometrial cancer. In contrast, in 115 patients who had endometrial thickness ≥5mm, 59 (51.3%) had endometrial cancer. Conclusion: Transvaginal ultrasonography may be used as a screening procedure in patients with postmenopausal bleeding. Diagnostic uterine curettage may be avoided in patients who had endometrial thickness≤4mm.