Document Detail

Accuracy of endometrial thickness in detecting benign endometrial pathology in postmenopausal women.
MedLine Citation:
PMID:  19587611     Owner:  NLM     Status:  MEDLINE    
OBJECTIVE: The aim of this study was to determine whether an endometrial thickness less than 5 mm on transvaginal ultrasound (TVUS) is sufficient to exclude benign endometrial lesions in postmenopausal women with bleeding and to determine a cutoff value below which benign endometrial pathology could be ruled out. METHODS: Electronic medical records of consecutive postmenopausal women presenting with vaginal bleeding suspicious for benign pathology were reviewed between September 2002 and December 2007. All women underwent TVUS with endometrial stripe measurement followed by saline infusion sonography (SIS). Accuracy of endometrial echo thickness for detecting intracavitary masses was compared with the reference standard of SIS. A receiver operating characteristic curve was constructed to calculate whether other cutoff values would be more accurate than 5 mm in detecting benign endometrial masses. RESULTS: A total of 1,097 women were referred during the study period; 135 met the inclusion criteria and underwent TVUS followed by SIS. The endometrial echo was less than 5 mm in 43% and 5 mm or greater in 57%. The overall prevalence of polyps or fibroids was 50%. Using an endometrial echo cutoff less than 5 mm, sensitivity was 76% (95% CI, 65-85), specificity was 63% (95% CI, 51-73), positive predictive value was 67%, and negative predictive value was 72%. The area under the receiver operating characteristic curve for detection of benign masses was 0.79 (95% CI, 0.72-0.87). We were unable to determine a cutoff value below which benign endometrial pathology could be excluded. CONCLUSIONS: With an endometrial thickness cutoff of 5 mm a considerable amount of benign endometrial pathology in postmenopausal women with bleeding is missed, and SIS or hysteroscopy may be warranted.
Malgorzata E Skaznik-Wikiel; J Eric Jelovsek; Brenda Andrews; Linda D Bradley
Publication Detail:
Type:  Evaluation Studies; Journal Article    
Journal Detail:
Title:  Menopause (New York, N.Y.)     Volume:  17     ISSN:  1530-0374     ISO Abbreviation:  Menopause     Publication Date:    2010 Jan-Feb
Date Detail:
Created Date:  2010-01-13     Completed Date:  2010-05-17     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9433353     Medline TA:  Menopause     Country:  United States    
Other Details:
Languages:  eng     Pagination:  104-8     Citation Subset:  IM    
Cleveland Clinic, Obstetrics, Gynecology & Women's Health Institute, Cleveland, OH, USA.
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MeSH Terms
Aged, 80 and over
Cohort Studies
Endometrial Neoplasms / ultrasonography*
Metrorrhagia / ultrasonography*
Middle Aged
Predictive Value of Tests
ROC Curve
Reference Values
Retrospective Studies
Sodium Chloride / diagnostic use
Reg. No./Substance:
7647-14-5/Sodium Chloride
Comment In:
Menopause. 2010 Jan-Feb;17(1):21-2   [PMID:  19952964 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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