[Ultrasound endometrium diagnosis]

Abstract

Ultrasound has been gaining significance in the recent past as diagnostic tool not only in obstetrics but also in general gynecology. Improvements of image resolution by transvaginal sonography [TVS] allow the investigation of even delicate anatomical structures such as the endometrium. Various diagnostic criteria including thickness of endometrium, internal structure and myometrial involvement help to identify endometrial abnormality. The benefits of new technologies such as colour Doppler and 3D sonography are currently being assessed. In the postmenopausal patient without hormonal substitution endometrial carcinoma may be diagnosed by measuring endometrial thickness alone. In women with postmenopausal bleeding endometrial atrophy as the must common cause has been differentiated from endometrial cancer with a high success rate. Considering that more than 70% of diagnostic currettages reveal benign sonography may significantly reduce the number of these procedures. In patients with hormonal replacement therapy the measurement of endometrial thickness is not reliable because the endometrium is subject to cyclical changes. Advantageous in this situation is the examination of the endo/myometrial borderline. The potential of sonography in reducing the number of currettages has to be assessed in larger scale prospective studies. Therefore a general screening for endometrial carcinoma is not advocated for the time being and should be restricted to high risk patients.