Endometrial Volume as a Predictor of Endometrial Pathology in Perimenopausal Uterine Bleeding

Document Type : Original Article

Author

Department of Obstetrics and Gynecology, Faculty of Medicine, Mansura University, Egypt.

Abstract

Background: Transvaginal ultrasonography (TVS) imaging is a
routine, non-invasive procedure in initial evaluation of patients with
abnormal uterine bleeding in perimenopausal age. However, there is
no yet a cutoff value to discriminate benign form malignant cases.
Aim of the Work: Is to assess the potential value of endometrial
volume measurements by 2D TVS compared with that of endometrial thickness in prediction of different endometrial pathologies in
women with perimenopausal uterine bleeding.
Patients and Methods: Ninety-two perimenopausal women presented with uterine bleeding were enrolled to the study after exclusion
of general and local caused of bleeding as polyps and fibroids. TVS
(2D) was done to measure endometrial thickness and volume using a
specific formula. Endometrial biopsy was taken and the pathological
results was correlated with the endometrial thickness and volume.
Results: There was a statistically noticeable difference between benign endometrial pathology compared to endometrial hyperplasia
with atypia or endometrial carcinoma as regard age as well as body
mass index. There was a high statistically significant difference between patients with benign endometrium pathology and malignant
endometrial pathology regarding endometrial thickness and volume.
That endometrial volume had a high predictive value as proved by
an area under the ROC curve (AUC) of 0.826. The best cut-off value
was an endometrial volume >11.675 cm3. While (ROC) curve analysis for differentiation of patients using endometrial volume and endometrial thickness into women with benign endometrial pathology
or hyperplasia and those with endometrial carcinoma; Endometrial
volume also had a higher predictive value than endometrial thickness
as proved by an area under the ROC curve (AUC) of 0.871. The
cut-off value was an endometrial volume >13.105 cm3. While using
endometrial thickness cut-off value was an endometrial thickness >
14.5mm.
Conclusion: endometrial volume measured with inexpensive 2D
TVS has a higher predictive value than measuring endometrial thickness in correspondence to the pathological results in patients with
perimenopausal bleeding.

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