| Accuracy of endometrial thickness in detecting benign endometrial pathology in postmenopausal women. | |
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MedLine Citation:
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PMID: 19587611 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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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. |
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Authors:
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Malgorzata E Skaznik-Wikiel; J Eric Jelovsek; Brenda Andrews; Linda D Bradley |
Publication Detail:
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Type: Evaluation Studies; Journal Article |
Journal Detail:
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Title: Menopause (New York, N.Y.) Volume: 17 ISSN: 1530-0374 ISO Abbreviation: Menopause Publication Date: 2010 Jan-Feb |
Date Detail:
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Created Date: 2010-01-13 Completed Date: 2010-05-17 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 9433353 Medline TA: Menopause Country: United States |
Other Details:
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Languages: eng Pagination: 104-8 Citation Subset: IM |
Affiliation:
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Cleveland Clinic, Obstetrics, Gynecology & Women's Health Institute, Cleveland, OH, USA. |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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Adult Aged Aged, 80 and over Algorithms Cohort Studies Endometrial Neoplasms / ultrasonography* Female Humans Metrorrhagia / ultrasonography* Middle Aged Postmenopause* Predictive Value of Tests ROC Curve Reference Values Retrospective Studies Sodium Chloride / diagnostic use |
| Chemical | |
Reg. No./Substance:
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7647-14-5/Sodium Chloride |
| Comments/Corrections | |
Comment In:
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Menopause. 2010 Jan-Feb;17(1):21-2
[PMID:
19952964
]
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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