ASSESSMENT OF THE POSTMENOPAUSAL ENDOMETR IUM BY TRANSVAGINAL SONOGRAPHY - A PROSPECTIVE-STUDY

Objective: The measurement of the endometrial thickness by means of tr ansvaginal sonography has been discussed as a tool for cancer screenin g. The aim of the study was to evaluate such a sonomorphological chara cterization of the endometrium performed by physicians in training. Me thods: A transvaginal sonography was performed in 400 patients before histological examination (dilatation and curettage or hysterectomy). T he endometrial thickness measured as double layer and the sonographic patterns were determined. Results: The endometrial thickness correlate d with the histological findings: the median thickness was 6 mm for th e normal endometrium and increased to 9 mm for polypiform hyperplasias 9.5 for cervical mucous polyps, and to 14 mm for glandular-cystic hyp erplasias and carcinomas (p < 0.001 vs. normal). The sonomorphological grading score was also associated with the histology. For the sonomor phological grading, the sensitivity decreased to 80%, but the specific ity increased to 62%. Conclusions: The sonomorphological pattern is su perior to the sole determination of the endometrial thickness. This me thod is practicable under routine conditions performed by physicians i n training. However, the specificity of both methods is too low to rec ommend them for cancer screening.