ANORMAL UTERİN KANAMASI OLAN OLGULARDA ULTRASONOGRAFİK BULGULAR ve HİSTOPATOLOJİK SONUÇLARI

Öz

Amaç: Anormal uterin kanama (AUK) ile başvuran kadınlarda transvajinal ultrasonografik (TvUSG ) değerlendirme, histopatolojik sonuçlarla karşılaştırılarak, tanıda TvUSG’nin yerini ortaya koymaktır. Gereçler ve Yöntem: Çalışmaya Ocak 2011- Mayıs 2020 yılları arasında AUK şikayeti ile başvurmuş, 19-86 yaş arasında, endometriyal biyopsi yapılmış 633 hasta dahil edildi. Hastaların TvUSG bulguları ile, histopatolojik sonuçları karşılaştırıldı. Bulgular: Değerlendirilen 633 hastanın yaş ortalaması 48,3±10,3(19-86), parite ortalaması 2,1±1,2 (0-9) ve vücut kitle indeksi ortalaması 25,71±3,4 (19-32) kg/m2 saptandı. Histopatolojik sonucu normal (proliferatif ve sekretuar endometrium) kabul edilen 316 (%49,9) hastada ortalama endometriyal kalınlık (EK) 8,34±2,49 mm (2-12) bulundu. 133 (%21,0) endometriyal polip vakasında ortalama EK 13,5±0,97 mm (12-20), 52(%8,21) atipisiz endometriyal hiperplazi (Asiz EH)’de ortalama EK 15,27±3,28 mm (4-22), 102 (%16,11) atipili endometriyal hiperplazinin (Ali EH) ortalama EK’ı 18,53±3,06 mm (5-23) saptandı. Tespit edilen 30(%4,73) endometriyal adenokarsinom vakasının ortalama EK 28,87±5,09 mm (24-47) ölçüldü. One way ANOVA ve Tukey post hoc analizlerine göre EK ölçümü tanı koyma ve biyopsi endikasyonları belirleme açısından istatiksel olarak anlamlı bulundu (p<0,001). Endometriyal biyopsi endikasyonu için EK’nın premenapozda 12 mm, postmenapozda 4 mm olarak kabul etmek Pearson ki-kare testi ile anlamlı bulundu (sırası ile p<0,05 ve p<0,01). Sonuç: AUK olan hastalarda TvUSG, uterin patolojilerin tanısını koyma ve biyopsi endikasyonunu belirlemede iyi bir görüntüleme yöntemidir.

Anahtar Kelimeler

• Anormal uterin kanama
• endometriyal kalınlık
• endometriyal biyopsi

THE ULTRASONOGRAPHIC FINDINGS IN ABNORMAL UTERINE BLEEDING CASES WITH THE HISTOPATHOLOGICAL RESULTS

Öz

Aim: Compare the relation between transvaginal ultrasonographic (TvUSG ) findings with histopathology in women with abnormal uterine bleeding (AUB) and determine the role in diagnosis. Materials and Method: 633 patients, attended between January 2011 - May 2020 with AUB, aged between 19-86 years, were included to th study. TvUSG findings were compared with histopathology. Results: The mean age of evaluated 633 patients was 48,3±10,3(19-86), mean parity 2,1±1,2 (0-9) and mean body mass index 25,71±3,4 (19-32) kg/m2. The mean endometrial thickness of 316 (%49,9) patients with normal pathology (proliferative and secretory endometrium) was found to be 8,34±2,49 mm (2-12). The mean endometrial thickness was detected as 13.5±0.97 mm (12-20) in 133(%21.0) cases with endometrial polyp , 15.27±3.28 mm (4-22) in 52(%8,21) in patients with endometrial hyperplasia without atypia and 18.53±3.06 mm (5-23) in 102(%16.11) in cases with endometrial hyperplasia with atypia. 30 (% 4.73) endometrial adenocarcinoma cases recorded to have 28,87±5,09 mm (24-47) mean endometrial thickness. According to One way ANOVA and Tukey post hoc analysis, measuring endometrial thickness was found to be statistically significant for diagnosis and defining biopsy indications (p<0,001). Also by the analysis with Pearson ki-square test, endometrial thickness >12 mm in the premenopausal period and >4 mm in the postmenopausal period were found to be statistically significant for biopsy indications (p<0,05 and p<0,01 in order). Conclusion: TvUSG is a primary visualising method for diagnosis of uterine pathologies and determining the endometrial biopsy indications in patients with AUB.

Anahtar Kelimeler

• Abnormal uterine bleeding
• endometrial thickness
• endometrial biopsy

Kaynakça

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