Abstract:

Objective To investigate the values of three-dimensional transvaginal sonograpphy and hysterosonography in early diagnosis of the endometrial diseases.Methods 74 patients with postmenopausal bleeding were studied prospectively.Endometrial thickness and volume were measured with 2D and 3D ultrasound respectively,endometrial thickness greater than 5 mm were found in 32 cases with hysterosonography.The changes of the endometrium and compliance of muscularis uteri were observed.The results were compared with histopathologic findings.Results When 10 mL of endometrial volume was set as the criticalor cut off-point of the endometrial abnormalities in postmenopausal women with bleeding,the sensitivity,specificity,positive predictive values and negative predictive value were 95.4%,78.8%,67.7%,97.6% respectively whereas 100%,66.7%,41.2%,100% were obtained respectively when it was used to predict endometrial malignancy and premalignancy.To identify endometrial disorders with 2D-SHG,the values above-mentioned were 100%,96.9%,95.0%,100% respectively whereas 100%,88.2%,86.7%,100% were obtained respectively for predicting endometrial malignancy and premalignancy.The changes of endometrium and compliance of muscularis uteri were significantly different between the groups of benign and malignant pathological changes when contrast medium was injected into uterine cavity(P<(0.05)).Conclusion 3D-TVS and 2D-SHG were reliable methods to diagnose endometrial disorders in postmenopausal women.2D-SHG should be viewed as an important tool in diagnosis and differentiation of endometrial pathological changes especially in the early stages of the malignant diseases.The changes of endometrium and compliance of muscularis uteri may serve as an effective diagnostic method for differentiation of benign endometrial disorders from endometrial cancer.

Key words: three-dimensional transvaginal sonography, hysterosonography, endometrial disorders, postmenopausal bleeding