ENDOMETRIAL THICKNESS AS MEASURED BY TRANSVAGINAL SONOGRAPHY - INTEROBSERVER VARIATION

Transvaginal sonography of the uterus has become an important tool for diagnosing endometrial pathology in women with postmenopausal bleedin g. One parameter that has been claimed to be important for early detec tion of endometrial pathology in this group of women is the endometria l thickness. The purpose of this study was to evaluate the reproducibi lity of measurements of endometrial thickness as performed by five ine xperienced doctors and one doctor experienced in the transvaginal sono graphy technique. The endometrial thickness as measured by the experie nced doctor was regarded as the 'true measurement', and the mean discr epancy from this true measurement was 1.5 mm for the inexperienced doc tors. No endometrial pathology was found at the histopathological exam ination after dilatation and curettage (D & C) when the endometrial th ickness was measured as less-than-or-equal-to 4 mm by both the inexper ienced and the experienced doctors. However, there were considerable d ifferences between the results obtained by the five inexperienced doct ors. If this method is to be used for identifying those women who will not have a D & C performed, based on the findings of a thin endometri um (less-than-or-equal-to 4 mm), training is needed in order to minimi ze the error. We believe that this will make measurement more accurate and it may then be used to exclude endometrial abnormality in women w ith postmenopausal bleeding.