阴道超声测量绝经前妇女子宫内膜厚度诊断子宫内膜病变

目的:探讨阴道超声测量子宫内膜厚度是否可用于预测绝经前妇女子宫内膜病变。方法:对87例绝经前不规则子宫出血患者行阴道超声测量子宫内膜厚度并于检查当日或次日行分段诊刮术,将阴道超声检查结果与诊刮获取的子宫内膜组织病理结果进行比较。结果:阴道超声测得子宫内膜癌及癌前病变组的内膜平均厚度为(27.3±11.0)mm,子宫内膜良性病变组的内膜平均厚度为(15.5±4.8)mm,均明显大于子宫内膜生理改变组的内膜平均厚度(9.8±4.3)mm,差异均有极显著性意义(P<0.0001)。以10mm为临界值阴道超声预测绝经前妇女子宫内膜病变的敏感性、特异性、阳性预测值、阴性预测值分别为95.9％、57.9％、74.6％和91.7％。结论:阴道超声测量子宫内膜厚度以10mm为临界值可以预测绝经前妇女子宫内膜病变。

Transvaginal Sonography of the Endometrial Thickness in Premenopausal Women for Identifying Endometrial Disorders.

To evaluate the use of transvaginal sonography (TVS)of the endometrial thickness in premenopausal women with irregular uterine bleeding for the diagnosis of endometrial abnormality. Methods:88 premenopausal patients with irregular utreine bleeding were studied prospectively. Transvaginal sonography was used to measure the endometrial thickness (double layers), and then, followed by fractional dilatation and curretage(D&C). The results of TVS were compared with the histopathologic diagnosis of specimens obtained by D&.C. Results: A significant difference was found between the group of endometrial malignancy and premaligancy the mean endometrial thickness of (27. 3±11. 0)mm and the group of normal endometrium(P<0. 0001). Also,the mean endometrial thickness of (15. 6±4. 8)mm for all other endometrial pathologies was found significantly thicker than that of (9. 8 ± 4. 3)mm for the normal endometrium(P<0. 0001). When the cutoff point of the endometrial thickness was set at 10mm to detect the endometrial abnormality, TVS showed a 95. 9% sensitivity,57. 9% specificity,74. 6% positive predictive value and 91. 7% negative predictive value respectively. Conclusion:Endometrial thickness of 10mm may serve as the cut - off point to identify the endometrial abnormality in premenopausal women