Achados da vídeo-histeroscopia em pacientes encaminhadas a um centro de referência para avaliação de alterações ultrassonográficas do endométrio

Abstract

Patients with early diagnose of gynecological cancer have a better lifespan. In the endometrium’s neoplasia, ultrasonography image shows alterations, without defining them. Considering the benefits likely to be obtained from endoscopic images, said differences were evaluated in an attempt to assure the integral care of patients with gynecological cancer in incidence. Objective: To analyze the incidence of alterations in a comparative study between hysteroscopy and ultrasonography results with abnormal endometrium. Methods: This is a review of 1561 endoscopic reports in the period from 1999 until 2005 performed at Santa Casa da Misericordia do Rio de Janeiro, amongst which 746 with athypical endometrium`s ultrasonography were selected. These reports were issued by different Radiographic Services. The accuracy of hysteroscopic images was evaluated in comparison with the ultrasonography images in patients with abnormal endometrium, and benign and complex images were separatedely examined. They were also examined during the reproductive and post-menopause periods. Results: The Qui-square study revealed a significant statistical meaning for comparison of the variables: ultrasound with abnormal endometrium versus hysteroscopy for the whole studied period. A large incidence of benign hypertrophies was found: polyps (58.7%); simple hypertrophies (13.3%); endometrium with inflammation (3.5%); fibromas (6.0%); others (17.6%); cavity without alterations (0.9%); a low incidence of complex hypertrophies was shown during the fertility period in comparison with 5.3 times more complex hypertrophies found during menopause. Conclusion: there is a compatibility between the ultrasound images of the modified endometrium and the histeroscopic diagnosis, but with better definition of image for the second method.