Аномальные маточные кровотечения. Анализ результатов ультрасонографии по системе IETA

Abstract

Objective. To study the features of the uterine cavity echo and the prognostic value of ultrasound signs of endometrial pathology in patients with abnormal uterine bleeding based on the terminology and recommendations of IETA. Patients and methods. The study included 196 women with abnormal uterine bleeding in the late reproductive period and premenopause and 54 patients with postmenopausal bleeding and/or ultrasound signs of endometrial pathology. All ultrasonography results were interpreted according to the IETA classification and terminology and were subsequently verified by histological examination. Results. In patients with endometrial intraepithelial neoplasia (EIN), the thickness of the endometrium was in the range of 9–19 mm and, according to this criterion, did not differ from endometrial hyperplasia without atypia. Only in some patients with EIN, the endometrial-myometrial junction was characterized by unevenness (16.7% in the reproductive period/premenopause and 22.2% in postmenopause). Compared with endometrial hyperplasia, EIN was dominated by uneven, heterogeneous echogenicity without cystic inclusions with a color scale 2–3 points. In endometrial cancer, the endometrial-myometrial junction was interrupted in 77.8–100% of cases, and the color score reached 4 points. Conclusion. Modern possibilities of ultrasonography allow improving the principles of early diagnosis of EIN and preinvasive endometrial carcinoma. Key words: ultrasound, IETA, endometrial cancer, endometrial intraepithelial neoplasia