Diagnosis of tuberculous endometritis with ultrasonography

Abstract

Objective To study the image features and diagnostic value of ultrasound in endometrial tuberculosis. Methods The ultrasound features of endometrial tuberculosis in 47 cases confirmed by operative pathology were reviewed retrospectively. All patients were examined by transvaginal color Doppler ultrasonography. The ultrasound features of endometrial morphology, internal echo and blood flow were summarized and analyzed. In addition, the ultrasound and intraoperative findings in the pelvic and abdominal cavity were also analyzed. Results The endometrial thickness of 47 patients was measured by transvaginal ultrasonography and the average thickness of monolayer endometrium was (0.31±0.15) cm. According to the findings on ultrasound images, 15 cases (31.9%) showed heterogeneous endometrial echo-texture, 12 cases (25.5%) showed intrauterine nodular lesions, 8 cases (17.0%) showed intrauterine echogenic focus, and 12 cases (25.5%) presented with thin endometrium. Additional ultrasonic findings of endometrial tuberculosis in the pelvic and abdominal cavity included 43 cases (91.5%) with fallopian tube inflammatory lesions, 11 cases (23.4%) with mesosalpinx cyst, and 9 cases (19.1%) with pelvic encapsulating effusion. The intraoperative findings included 45 cases (95.7%) with pelvic and abdominal tissue adhesion, and 23 cases (48.9%) with pelvic and abdominal miliary nodules. Conclusions The endometrial tuberculosis showed various ultrasonic manifestations without any specific features. Thus, it is necessary to make a comprehensive analysis of the patient′s medical history and clinical examinations to reach the final diagnosis, in which ultrasound findings of oviduct tuberculosis can provide very helpful diagnostic information. Key words: Endometrium; Tuberculosis; Ultrasonography