Роль трансвагинальной соноэластографии в дифференциации злокачественной и доброкачественной патологии эндометрия у женщин в постменопаузе

Abstract

Objective. To study the clinical significance of transvaginal sonoelastography (TVSE) in the differential diagnosis of endometrial hyperplasia and carcinoma. Patients and methods. Fifty-four patients with postmenopausal bleeding and/or ultrasound features of endometrial pathology (mean age: 67.8 ± 3.2 years) were examined. The average length of postmenopause was 8.12 ± 3.4 years. The strain index (SI), which was measured automatically, was used as the main criterion of TVSE. Results. The mean SI varied widely depending on the histological type of endometrial pathology: 2.0 (0.8–4.0) in patients with endometrial carcinoma; 1.6 (0.4–3.2) in patients with atypical endometrial hyperplasia; 0.8 (0.30–1.60) in patients with endometrial hyperplasia without atypia; 0.6 (0.5–2.40) in patients with endometrial polyps against the background of mucosal atrophy. A significant difference for SI was found only when comparing the group of patients with carcinoma with other groups, regardless of the morphological type of benign pathology (p < 0.05). Conclusion. TVSE allows to supplement the results of transvaginal ultrasound according to IETA (International Endometrial Tumor Analysis) system and improve the differential diagnosis of endometrial carcinoma with other benign endometrial pathologies. Key words: transvaginal ultrasound, sonoelastography, endometrial carcinoma, endometrial hyperplasia, endometrial polyps, strain index