围绝经期和绝经后妇女异常子宫出血的超声波检查子宫内膜厚度及其与组织病理学的相关性

Pramila Jena, Priti Mishra, Somya Ranjan Panda, Jyochanmati Panda, Sourav Padhee, Sibanarayan Rath
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摘要

子宫内膜是女性生育期的一个动态器官,因为它在每个周期都会受到激素变化的影响。本研究旨在将出现异常子宫出血(AUB)的围绝经期女性的子宫内膜厚度与组织病理学相关联,并确定子宫内膜厚度的临界值,以便就何时进行干预达成共识,从而避免遗漏任何一个子宫内膜病变。这是一项观察性研究,对象是 242 名年龄≥40 岁、出现异常子宫出血(AUB)的围绝经期和绝经后妇女:根据 ROC 曲线,子宫内膜厚度的异常组织学和正常组织学的分界点为 14.20 毫米。曲线下面积(AUC)为 0.783,95% CI 为 0.686 - 0.880,灵敏度为 71%,特异度为 90%(P < 0.001)。在这些年龄组中,月经出血量多和周期频繁通常与妇科疾病有关。对于所有绝经后和围绝经期的 AUB,经阴道超声检查子宫内膜厚度是最初的最佳检查方式。子宫内膜厚度在≥ 14 毫米范围内是最重要的。
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Endometrial thickness by ultrasonography and its correlation with histopathology in abnormal uterine bleeding among peri and post menopausal women
The endometrium constitutes a dynamic organ in female reproductive years, as it is subjected to hormonal variations in every cycle. Present study was conducted with the aim to correlate the endometrial thickness with the histopathology in the peri-menopausal females presenting with abnormal uterine bleeding (AUB) and to identify cut off value of endometrial thickness in order to reach at some consensus regarding when to intervene so that not a single endometrial pathology will be missed.This was an observational study conducted on 242 peri-menopausal and post-menopausal women ≥40 years of age presenting with abnormal uterine bleeding (AUB).: Based on the ROC curve, the cutoff point that delineates the abnormal histology and normal histology for endometrial thickness was 14.20 mm. Area under the curve (AUC) was 0.783 with 95% CI as 0.686 - 0.880 having sensitivity 71% and specificity 90% (p < 0.001). Heavy menstrual bleeding and frequent cycle were found to be commonly associated with gynecological pathology in these age groups. In all post and peri-menopausal AUB trans vaginal sonography for endometrial thickness is the initial best modality of investigation. Endometrial thickness cutoff in the range of ≥ 14 mm is of prime importance.
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