Journal of Ultrasound in Medicine, Vol 13, Issue 2 99-104, Copyright © 1994 by American Institute of Ultrasound in Medicine
Comparison of transvaginal sonography with endometrial biopsy in asymptomatic postmenopausal women
C. F. Shipley 3rd, C. L. Simmons and G. H. Nelson
The purpose of this study was to compare TVS with endometrial biopsy as a
screening technique in asymptomatic postmenopausal women. Asymptomatic
postmenopausal women were recruited by newspaper advertisement. Each study
patient was subjected to pelvic examination and TVS followed by endometrial
biopsy. Patients with suspected endometrial abnormalities by TVS (normal by
endometrial biopsy) were evaluated further with hysteroscopy with biopsy or
D~C or both. Eight patients were identified as having abnormalities by TVS,
only one of whom had abnormalities by initial endometrial biopsy. Two
patients were identified as having abnormalities by endometrial biopsy and
normal by TVS. Further evaluation of the seven patients identified as
having abnormalities by TVS (normal by endometrial biopsy) documented all
seven patients as having abnormalities. The total yield of abnormalities
with TVS was 16% (eight of 50 patients). The total yield of abnormalities
with endometrial biopsy was 6% (three of 50 patients). The sensitivity of
TVS in identifying endometrial abnormalities was 80% (eight of 10), while
endometrial biopsy was only 30% (three of 10). TVS was more sensitive in
detecting endometrial abnormalities, including endometrial hyperplasia,
than was endometrial biopsy. The use of endometrial biopsy as a screening
technique in asymptomatic postmenopausal patients is questioned.
