| ACR Appropriateness Criteria(®) on Abnormal Vaginal Bleeding. | |
| | |
MedLine Citation:
|
PMID: 21723482 Owner: NLM Status: In-Data-Review |
Abstract/OtherAbstract:
|
In evaluating a woman with abnormal vaginal bleeding, imaging cannot replace definitive histologic diagnosis but often plays an important role in screening, characterization of structural abnormalities, and directing appropriate patient care. Transvaginal ultrasound (TVUS) is generally the initial imaging modality of choice, with endometrial thickness a well-established predictor of endometrial disease in postmenopausal women. Endometrial thickness measurements of ≤5 mm and ≤4 mm have been advocated as appropriate upper threshold values to reasonably exclude endometrial carcinoma in postmenopausal women with vaginal bleeding; however, the best upper threshold endometrial thickness in the asymptomatic postmenopausal patient remains a subject of debate. Endometrial thickness in a premenopausal patient is a less reliable indicator of endometrial pathology since this may vary widely depending on the phase of menstrual cycle, and an upper threshold value for normal has not been well-established. Transabdominal ultrasound is generally an adjunct to TVUS and is most helpful when TVUS is not feasible or there is poor visualization of the endometrium. Hysterosonography may also allow for better delineation of both the endometrium and focal abnormalities in the endometrial cavity, leading to hysteroscopically directed biopsy or resection. Color and pulsed Doppler may provide additional characterization of a focal endometrial abnormality by demonstrating vascularity. MRI may also serve as an important problem-solving tool if the endometrium cannot be visualized on TVUS and hysterosonography is not possible, as well as for pretreatment planning of patients with suspected endometrial carcinoma. CT is generally not warranted for the evaluation of patients with abnormal bleeding, and an abnormal endometrium incidentally detected on CT should be further evaluated with TVUS. |
| | |
Authors:
|
Genevieve L Bennett; Rochelle F Andreotti; Susanna I Lee; Sandra O Dejesus Allison; Douglas L Brown; Theodore Dubinsky; Phyllis Glanc; Donald G Mitchell; Ann E Podrasky; Thomas D Shipp; Cary Lynn Siegel; Jade J Wong-You-Cheong; Carolyn M Zelop |
Publication Detail:
|
Type: Journal Article |
Journal Detail:
|
Title: Journal of the American College of Radiology : JACR Volume: 8 ISSN: 1558-349X ISO Abbreviation: J Am Coll Radiol Publication Date: 2011 Jul |
Date Detail:
|
Created Date: 2011-07-04 Completed Date: - Revised Date: - |
Medline Journal Info:
|
Nlm Unique ID: 101190326 Medline TA: J Am Coll Radiol Country: United States |
Other Details:
|
Languages: eng Pagination: 460-8 Citation Subset: IM |
Copyright Information:
|
Copyright © 2011 American College of Radiology. Published by Elsevier Inc. All rights reserved. |
Affiliation:
|
New York University Medical Center, New York, New York. |
Export Citation:
|
APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
|
|
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
Previous Document: Salivary gland nocardiosis in an immunocompetent patient.
Next Document: Self-referral in medical imaging: a meta-analysis of the literature.