The diagnostic value of transvaginal sonography in the diagnosis of endometrial malignancy in women with peri- and postmenopausal bleeding.

The purpose of this study was to evaluate transvaginal sonography and curettage in the diagnosis of endometrial malignancy in women with peri-, and postmenopausal bleeding. Diagnostic curettage has been the method of choice to diagnose endometrial cancer. The purpose of this study was also to evaluate the value of transvaginal sonography in decreasing the number of curettages, because the costs of curettage are huge today and only 10% of the women in this group will be diagnosed with endometrial cancer. Transvaginal sonography was performed on 353 women with peri- or postmenopausal bleeding before curettage. Endometrial malignancy was found in 42 patients, in 12/242 (5%) of women aged less than 60 years and 30/111 (27%) of women aged 60 years or more. All the patients with endometrial cancer had an endometrial thickness of 6 mm or more measured by transvaginal sonography. The sensitivity of ultrasound to detect malignancy was 100%, the specificity was 43.4%, the positive and negative predictive values were 19.2% and 100%. If the limit of 6 mm of endometrial thickness had been used in this study, 38.2% of the curettages could have been avoided.