Document Detail


Radiological reasoning: algorithmic workup of abnormal vaginal bleeding with endovaginal sonography and sonohysterography.
MedLine Citation:
PMID:  19018052     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: The workup of endometrial abnormalities can be a confusing task for radiologists because one must take into account the patient's clinical history, imaging findings, and a wide array of diagnostic options. We present two cases, one of a premenopausal woman presenting with vaginal bleeding and another of a postmenopausal woman taking tamoxifen who has abnormal findings on endovaginal sonography. The evaluations of these patients serve to illustrate the diagnostic algorithm for identification of endometrial pathology. CONCLUSION: Imaging plays a central role in the algorithm for detection of endometrial disorders in women with abnormal vaginal bleeding. Endovaginal sonography is used to identify mural abnormalities such as fibroids and adenomyosis and to screen for thickened endometria that require nonfocal biopsy for the diagnosis of cancer or hyperplasia. Sonohysterography serves as a triage tool to detect focal abnormalities of the endometrial cavity, such as endometrial polyps or subendometrial fibroids, thereby identifying those women who require more invasive workup with hysteroscopy.
Authors:
Ann A Shi; Susanna I Lee
Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  AJR. American journal of roentgenology     Volume:  191     ISSN:  1546-3141     ISO Abbreviation:  AJR Am J Roentgenol     Publication Date:  2008 Dec 
Date Detail:
Created Date:  2008-11-21     Completed Date:  2009-01-08     Revised Date:  2009-02-22    
Medline Journal Info:
Nlm Unique ID:  7708173     Medline TA:  AJR Am J Roentgenol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  S68-73     Citation Subset:  AIM; IM    
Affiliation:
Department of Radiology, Massachusetts General Hospital, Boston, MA, USA. ashi@montefiore.org
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MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Algorithms*
Decision Support Systems, Clinical*
Female
Humans
Ultrasonography / methods*
Uterine Hemorrhage / ultrasonography*
Vagina / ultrasonography*
Vaginal Diseases / ultrasonography*
Comments/Corrections
Erratum In:
AJR Am J Roentgenol. 2009 Mar;192(3 Suppl):S62

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


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