ENDOMETRIAL ASSESSMENT BY TRANSVAGINAL SONOGRAPHY AND HISTOLOGICAL-FINDINGS AFTER D-AND-C IN WOMEN WITH POSTMENOPAUSAL BLEEDING

A total of 149 women with postmenopausal bleeding underwent transvagin al sonography, hysteroscopy and dilatation and curettage in order to s tudy the diagnostic accuracy of several ultrasound parameters in asses sing endometrial pathology, and to determine the most sensitive cut-of f value of endometrial thickness for the exclusion of endometrial lesi ons. In distinguishing pathological from normal endometrium, transvagi nal sonography showed a sensitivity of 69.3%, specificity of 82.7%, po sitive predictive value of 74.1% and negative predictive value of 72.1 %. rn detecting premalignant and malignant endometrial pathology, tran svaginal sonograph), showed a sensitivity, specificity positive predic tive value and negative predictive value of 55%, 96.1%, 68.7% and 93.2 %, respectively. Considering endometrial thickness as a single paramet er, the most sensitive cut-off for defining normality was 4 mm; nevert heless, in the group of patients that had an endometrial thickness les s than 4 mm, there was one case of malignancy (sensitivity, 95.2%; spe cificity, 49.4% positive predictive value, 57.3%; and negative predict ive value, 93.5%). Transvaginal sonography combined evaluation (morpho logy, thickness and color Doppler) showed a pool diagnostic accuracy i n detecting endometrial pathology and in differentiating between endom etrial benign lesions, endometrial polyps and adenocarcinoma in women with postmenopausal bleeding Endometria( thickness evaluated with tran svaginal sonography was preferable but not sensitive enough to exclude endometrial pathology.