POSTMENOPOZAL VAJİNAL KANAMALI OLGULARDA TRANSVAJİNAL ULTRASONOGRAFİ VE BİOPSİ SONUÇLARININ KARŞILAŞTIRILMASI

Öz

Amaç: Postmenopozal kanaması olan hastaların endometrial transvajinal ultrasonografi (TvUSG) bulgularının histopatoloji bulgularıyla karşılaştırılması ve TvUSG'nin endometrial patolojilerin değerlendirilmesindeki etkinliğinin belirlenmesi. Materyal ve Metod: Çalışmada 01.01.2009-30.11.2012 tarihleri arasında postmenopozal kanama nedeni ile takip edilen 135 hasta retrospektif olarak değerlendirildi. Tüm hastalara TvUSG ile endometrial kalınlık ölçümünü takiben endometrial biyopsi yapıldı. Yaş ve endometrial kalınlığın malignite ve patoloji varlığı ile ilişkisi araştırıldı. Sayısal veriler ortalama +/- standart sapma (SD) veya ortanca (minimum-maksimum) olarak ifade edildi. Bulgular: Hastaların yaş ortalaması 54±8 olarak bulundu. Patoloji tespit edilen hastalar 10mm (5-40); patolji tespit edilmeyen hastalar ise 7mm (2-13) endometrial kalınlığa sahipti (p<0.001). 7.5 mm eşik değer kabul edildiğinde patoloji varlığı %82 sensitivite ve %58 spesifite ile tespit edilebilmekteydi (AUC=0.82; p<0.001). Malign hastalar 11.5 mm (5-40); benign olanlar ise 8mm (7-27) endometrial kalınlığa sahipti (p=0.001). 8.5 mm eşik değer kabul edildiğinde malignite %83 sensitivite ve %56 spesifite ile tespit edilebilmekteydi (AUC=0.78; p=0.001). Sonuç: Kurumumuza postmenopozal kanama ile başvuran hastalarda TvUSG ile endometrial kalınlığın değerlendirilmesi, endometrial patoloji ve malignite varlığını yüksek duyarlılıkla tespit edebilmektedir.

Anahtar Kelimeler

• Postmenopozal Kanama, Endometrial Kal›nl›k, Transvajinalsonografi.

Öz

Objective: To compare the endometrial transvaginal ultrasonography (TvUSG) findings with histopathology and to assess the efficacy of TvUSG for detecting endometrial pathologies in patients with postmenopausal bleeding. Material-Methods: One hundred and thirty-five patients who refered between 01.01.2009-30.11.2012 with the complaint of postmenopausal bleeding were retrospectively evaluated. After measuring endometrial thickness with TvUSG, endometrial sampling was performed and the histopathology results were compared with ultrasonographic findings. Results: The average age of patients was 54±8. Median endometrial thickness was 10mm in pathologic group (5-40); and 7mm in nonpathologic group (2-13) (p<0.001). When 7.5 mm has been accepted as cut-off value, the pathology has been detected with 82% sensitivity and 58% specificity (AUC=0.82; p<0.001). Median endometrial thickness was 11.5 mm (5-40) in patients with malignity and 8 mm (7-27)in benign patients (p=0.001). When 8.5 mm has been accepted as cut-off value, the pathology has been detected with 83% sensitivity and 56% specificity (AUC=0.78; p=0.001). Conclusions The evaluation of endometrial thickness can detect presence of pathology or malignity with high sensitivity in patients referred with postmenopausal bleeding in our clinic

Anahtar Kelimeler

• Postmenopausal Bleeding, Endometrial Thickness, Transvaginal Ultrasonography.

Kaynakça

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