Role of transvaginal ultrasonography in diagnosing endometrial hyperplasia in pre- and post-menopause women

Abstract

Background: Abnormal uterine bleeding (AUB) is the most common presenting symptom of endometrial hyperplasia (EH). Transvaginal ultrasonography (TVS) is a diagnostic tool in the evaluation of AUB and EH with various sensitivity and specificity. However, the exact accuracy of TVS in diagnosing EH had not been evaluated. In this study, we aim to evaluate the accuracy of TVS in detecting EH.

Materials and methods: In this retrospective study, 120 women (mean age of 48.64 ± 6.74 years) with AUB with suspicious/or possible EH were evaluated. TVS and pathology findings of possible EH were recorded. Sensitivity, specificity, positive, and negative predictive value (PPV and NPV) was calculated.

Results: Sixty-eight patients were premenopause, and 52 were postmenopause. TVS reported EH in 85 cases (70.83%). Pathology results showed EH in 85 cases (70.83%) including simple cystic hyperplasia in 82 cases, atypical, simple hyperplasia in one case and complex hyperplasia in two cases. Among these 85 cases, EH was confirmed by pathology in 81 cases. The accuracy, sensitivity, specificity, PPV, and NPV were 88.25%, 90.7%, 84%, 97.7%, and 84% in premenopause and 100% in postmenopause women.

Conclusion: TVS is an appropriate diagnostic tool in premenopause and postmenopause women presenting with AUB, especially in detecting EH. However, further studies are needed to determine the exact accuracy of TVS in diagnosing TVS.

Keywords: Abnormal uterine bleeding; endometrial hyperplasia; transvaginal ultrasonography.