THE SENSITIVITY AND SPECIFICITY OF VAGINAL SONOGRAPHY IN DETECTING ENDOMETRIAL ABNORMALITIES IN WOMEN WITH POSTMENOPAUSAL BLEEDING

Objective: To evaluate the sensitivity and specificity of vaginal sono graphy in the detection of endometrial abnormalities in patients with postmenopausal bleeding (PMB). Methods: In a prospective study, 54 pat ients with PMB were examined with vaginal ultrasonography prior to dil atation and curettage. The mean endometrial thickness was compared wit h the histopathological results. A cutoff value of 5 mm was prospectiv ely chosen to evaluate the sensitivity and specificity of this method. Results: The calculated sensitivity for the measurement of endometria l thickness as a predictor of endometrial pathology was 89%, and the s pecificity was 83%. We found carcinoma associated with an endometrial thickness of 6 mm. Conclusions: Although its sensitivity was high, we feel that an endometrial thickness >5 mm should constitute a cause for concern but not a definitive indication of pathology. Thus we believe that, at this point, the role of vaginal sonography as an aid in dete rmining which women with PMB should undergo curettage has yet to be de termined. (C) 1996 John Wiley & Sons, Inc.