Prediction of Benign and Malignant Endometrial Disease: Hysterosonographic-Pathologic Correlation

Dubinsky, Theodore J.; Stroehlein, Kristine; Abu-Ghazzeh, Yaser; Parvey, H. Richard; Maklad, Nabil F.

doi:10.1148/radiology.210.2.r99fe37393

Cited by 60 publications

(23 citation statements)

References 10 publications

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“…Goldstein e Schwartz 21 , em 109 HSNG, tiveram 10 casos de espessamento endometrial, sendo apenas cinco hiperplasias (acerto de 50%). Laughead e Stones 22 , em 114 HSNG, tiveram 19 casos de espessamento endometrial, sendo apenas quatro hiperplasias (acerto de 21%), e Dubinsky et al 23 , em 88 HSNG, tiveram 30 casos de espessamento endometrial, com nenhum caso de hiperplasia.…”

Section: Discussionunclassified

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A Histerossonografia na Avaliação da Cavidade Uterina em Pacientes Menopausadas

Júnior

Melo

Neto

2002

Rev. Bras. Ginecol. Obstet.

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Muitas delas serão submetidas à ultra-sonografia endovaginal como rotina ou para avaliação de sangramento uterino anormal, e apresentarão alterações na cavidade uterina. Em 60% das mulheres com sangramento pós-menopausa, nenhuma causa orgânica é encontrada. Karlsson et al. 2 , em estudo multicêntrico randomizado com 1168 pacientes menopausadas com sangramento vaginal, não tiveram nenhum caso de câncer em casos com espessura endometrial menor ou igual a

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Section: Discussionunclassified

“…Dubinsky et al 23 em 88 pacientes tiveram nove casos de câncer, e a HSNG teve sensibilidade de 89%, especificidade de 46%, VPP de 16% e VPN de 97%.…”

Section: Discussionunclassified

A Histerossonografia na Avaliação da Cavidade Uterina em Pacientes Menopausadas

Júnior

Melo

Neto

2002

Rev. Bras. Ginecol. Obstet.

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“…Endometrial polyps were ruled out by an office hysteroscopic procedure in women with thickened endometrium. Premenopausal women without any symptoms underwent imaging at least twice, and persistence of an early-proliferative-phase endometrium thicker than 12 mm was an indication for office hysteroscopy and endometrial sampling (6). The final outcome was categorized as resolution, persistence, or progression based on the findings either at hysterectomy or in the two final, consecutive endometrial samples.…”

Section: Methodsmentioning

confidence: 99%

Ultrasonographic endometrial thickness measurement is predictive for treatment response in simple endometrial hyperplasia without atypia

Özkaya

Korkmaz

Özkaya

et al. 2013

J Turkish German Gynecol Assoc

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Objective: We sought to determine the predictors of treatment response in simple endometrial hyperplasia without atypia. Material and Methods:We prospectively treated 67 women with simple endometrial hyperplasia without atypia who were administered cyclic oral medroxyprogesterone acetate 10 mg/day for 12 days of luteal phase for 3 months and underwent control endometrial sampling after treatment. All subjects were evaluated in terms of age, gravidity, parity, body mass index (BMI), menstrual cycle, endometrial thickness, uterine fibroids, ovarian cysts, serum CA 125 levels, systemic disorders and cigarette smoking. All parameters were used to predict treatment success.Results: Persistent hyperplasia was observed in 11 subjects. Endometrial thickness was significantly correlated with treatment failure (r=0.293, p=0.015). In ROC analysis, endometrial thickness was found to be predictive for persistent hyperplasia (area under curve: 0.724, P=0.019). Optimal cut off value was calculated to be 16.5 mm with 64% sensitivity, 72% specificity and 91% negative predictive value. The number of persistent hyperplasia in women with and without endometrial thickness greater than 16.5 mm was significantly different (7/23 vs. 4/45, p=0.029). Odds ratio of endometrial thickness higher than 16.5 mm for treatment failure was 4.4 (95% CI, 1.2-17.4, p=0.03). Conclusion:Results of this study suggest treatment modification according to the baseline endometrial thickness in patients with simple endometrial hyperplasia without atypia. (J Turkish-German Gynecol Assoc 2013; 14: 19-22) Key words: Endometrial hyperplasia, medroxyprogesterone acetate, endometrial thickness, ultrasonography, atypia Received: 13 October, 2012 Accepted: 8 February, 2013 Amaç: Bu çalışma ile atipisiz endometriyal hiperplazide tedaviye cevabı öngören faktörlerin belirlenmesi amaçlandı. Gereç ve Abstract ÖzetOriginal Investigation 19

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“…Furthermore, also Doppler studies of the endometrial vasculature have not been found helpful for this purpose, since no significant differences have been demonstrated between resistance and pulsatility indices in benign vs malignant causes of endometrial thickening [35,36]. Sonohysterography provides exquisite demonstration of the endometrial cavity and is able to describe accurately the morphological characteristics of endometrial lesions; however, it cannot provide differentiation between benign lesions and malignancies with absolute certainty, and all women with endoluminal masses still require histological evaluation to verify the presence of malignant disease [5,37,38,39,40].…”

Section: Abnormal Bleedingmentioning

confidence: 99%

Ultrasound in gynecology

et al. 2001

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This paper reviews the various examination techniques, the clinical indications, and the imaging findings for US studies of the female pelvis in patients with gynecological problems. Ultrasound, in fact, is the preferred imaging modality in the study of the female pelvis, and provides information of basic importance in detecting and characterizing pelvic masses of uterine, ovarian, or adnexal origin, providing also criteria useful in predicting their benign vs malignant nature. In patients with abnormal bleeding, transvaginal US helps in determining the presence of morphological and structural changes of the endometrium and, with the use of sonohysterography, provides excellent delineation of the endometrial cavity, guiding appropriate planning of therapeutic procedures. Ultrasound plays a very important role in the evaluation of patients with acute pelvic pain. It allows identification of ovarian torsion and has both diagnostic and therapeutic capabilities in patients with pelvic inflammatory disease through guidance of abscess drainage via the transvaginal route. In suspected ectopic pregnancy, US, together with quantitative measurements of hCG levels, can be considered the best imaging procedure to guide to the diagnosis. Ultrasound has an important role also in the study of female infertility. In this field it can be used to identify and document the integrity of the reproductive tract as a conduit for the passage of gametes and embryos, to detect pathological changes that may be causes or contributing factors of female infertility, to monitor cyclic changes of pelvic organs to document normal physiology or pathological situations, and to guide infertility treatment.

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Prediction of Benign and Malignant Endometrial Disease: Hysterosonographic-Pathologic Correlation

Abstract: A thin endometrium or diffuse smooth endometrial thickening is predictive of benign endometrial histologic findings, but all women with endoluminal masses require further histologic evaluation to exclude malignant disease.

Cited by 60 publications

References 10 publications

A Histerossonografia na Avaliação da Cavidade Uterina em Pacientes Menopausadas

A Histerossonografia na Avaliação da Cavidade Uterina em Pacientes Menopausadas

Ultrasonographic endometrial thickness measurement is predictive for treatment response in simple endometrial hyperplasia without atypia

Ultrasound in gynecology

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