ANORMAL UTERİN KANAMASI OLAN OLGULARDA ULTRASONOGRAFİK BULGULAR ve HİSTOPATOLOJİK SONUÇLARI

Yıl 2021, Cilt: 18 Sayı: 2, 800 - 804, 01.07.2021

Özlem Özgür Gürsoy , Hulusi Göktuğ Gürer , Ceren Yıldız Eren

https://doi.org/10.38136/jgon.834989

Cited By: 1

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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