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Chapter 6 - Sonographic Assessment of Endometrial Pathology

Published online by Cambridge University Press:  28 February 2020

Kanna Jayaprakasan ,
Lukasz Polanski  and
Kamal Ojha
By
Thierry Van den Bosch
Kanna Jayaprakasan
Affiliation:
Department of Maternity and Gynaecology, Royal Derby Hospital, Derby
Lukasz Polanski
Affiliation:
Assisted Conception Unit, Guy’s Hospital, London
Kamal Ojha
Affiliation:
Department of Obstetrics and Gynecology, St George's University Hospital, London
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Summary

Endometrial pathology includes hyperplasia, polyps, cancer and infection. Intracavitary fibroids are sensu stricto not endometrial lesions, but should be included in the differential diagnosis.

Although intracavitary pathology may be found incidentally while scanning for an unrelated reason, most patients will be diagnosed during the evaluation of abnormal uterine bleeding. Ultrasound examination is the test of choice to triage patients for further management. If a thin and regular endometrium is seen after menopause, endometrial atrophy is the most likely diagnosis, while the risk for malignancy is very low(Figure 6.1).

Type
Chapter
Information
Gynaecological Ultrasound Scanning
Tips and Tricks
 , pp. 79 - 86
Publisher: Cambridge University Press
Print publication year: 2020

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References

Timmermans, A, Opmeer, BC, Khan, KS, et al. Endometrial thickness measurement for detecting endometrial cancer in women with postmenopausal bleeding: a systematic review and meta-analysis. Obstet Gynecol 2010;116(1):160–7.Google Scholar
Van den Bosch, T, Van Schoubroeck, D, Domali, E, et al. A thin and regular endometrium on ultrasound is very unlikely in patients with endometrial malignancy. Ultrasound Obstet Gynecol 2007;29(6):674–9.CrossRefGoogle ScholarPubMed
Van den Bosch, T, Ameye, L, Van Schoubroeck, D, Bourne, T, and Timmerman, D. Intra-cavitary uterine pathology in women with abnormal uterine bleeding: a prospective study of 1220 women. Facts Views Vis Obgyn 2015;7(1):17–24.Google ScholarPubMed
Leone, FP, Timmerman, D, Bourne, T, et al. Terms, definitions and measurements to describe the sonographic features of the endometrium and intrauterine lesions: a consensus opinion from the International Endometrial Tumor Analysis (IETA) group. Ultrasound Obstet Gynecol 2010;35(1):103–12.CrossRefGoogle ScholarPubMed
Naftalin, J, Jurkovic, D. The endometrial–myometrial junction: a fresh look at a busy crossing. Ultrasound Obstet Gynecol 2009;34(1):1–11.CrossRefGoogle Scholar
Votino, A, Van den Bosch, T, Installe, AJ, et al. Optimizing the ultrasound visualization of the endometrial–myometrial junction (EMJ). Facts Views Vis Obgyn 2015;7(1):60–3.Google Scholar
Timmerman, D, Verguts, J, Konstantinovic, ML, et al. The pedicle artery sign based on sonography with color Doppler imaging can replace second-stage tests in women with abnormal vaginal bleeding. Ultrasound Obstet Gynecol 2003;22(2):166–71.CrossRefGoogle ScholarPubMed
de Kroon, CD, de Bock, GH, Dieben, SW, et al. Saline contrast hysterosonography in abnormal uterine bleeding: a systematic review and meta-analysis. BJOG 2003;110(10):938–47.CrossRefGoogle ScholarPubMed
Van den Bosch, T, Betsas, G, Van Schoubroeck, D, et al. Gel infusion sonography in the evaluation of the uterine cavity. Ultrasound Obstet Gynecol 2009;34(6):711–14.CrossRefGoogle ScholarPubMed
Werbrouck, E, Veldman, J, Luts, J, et al. Detection of endometrial pathology using saline infusion sonography versus gel instillation sonography: a prospective cohort study. Fertil Steril 2011;95(1):285–8.CrossRefGoogle ScholarPubMed
Van den Bosch, T, Van Schoubroeck, D, Van Calster, B, Cornelis, A, Timmerman, D. Pre-sampling ultrasound evaluation and assessment of the tissue yield during sampling improves the diagnostic reliability of office endometrial biopsy. J Obstet Gynaecol 2012;32(2):173–6.CrossRefGoogle ScholarPubMed

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