Structure of Hyperplastic Processes of the Uterus in Menopausal Women According to the Results of an Echographic Study

Abstract

The purpose of the study was to evaluate the results of ultrasound scanning in menopausal women with endometrial hyperplastic processes. Materials and methods. Ultrasound protocols of 67 menopausal women with uterine hyperplastic processes were analyzed. Endometrial imaging data were assessed as corresponding to focal endometrial hyperplasia in 53 (79.1%) women. Uterine fibroids in combination with endometrial hyperplasia were found in 42 (62.7%) menopausal patients. According to the transvaginal ultrasound protocols, only endometrial polyp was detected in 20.9% of women (n=14). Results and discussion. The main complaints of patients with endometrial hyperplastic processes were abnormal uterine bleeding and abdominal pain. Every third (n=22; 32.8%) woman in the menopausal period noted uterine bleeding. Every second patient complained of lower abdominal pain of varying intensity (n=34; 50.7%). 11 (16.4%) women had no complaints. All the women studied underwent transvaginal and transabdominal ultrasound (in 3D mode). Ultrasound examination of the pelvic organs in order to differentiate endometrial pathology in 54% of cases was performed twice and more often. Ultrasound examination of the uterus was performed in standard projections. Endometrial polyps in most cases were oval in shape and were visualized quite clearly due to high echogenicity, homogeneous structure, the presence of a base that has no connection with the myometrium, and the integrity of the basal layer in the area of attachment of the polyp base. The sizes of endometrial polyps ranged from 1 mm to 90 mm (12.6 ± 3.5 mm). Small polyps were more often of increased echogenicity and homogeneous structure. At the same time, patients with endometrial polyps in the menopausal period often lack their visualization during transvaginal ultrasound. They are often verified as a focal or diffuse form of endometrial hyperplasia, while the low frequency of diagnosis of polyps in the menopausal period is determined. Ultrasound results were interpreted as corresponding to a combination of focal hyperplasia and endometrial polyp in 16.4% of cases (n=11). Ultrasound with color Doppler mapping in endometrial cancer revealed a sharp increase in the blood flow rate in the arсuate arteries (Vmax = 0.33 ± 0.06 m/s, Vmin = 0.16 ± 0.1 m/s). Conclusion. Ultrasound is an affordable method for diagnosing hyperplastic processes of the uterus. In the diagnosis and determination of the structure of hyperplastic processes of the uterus, combined transabdominal and transvaginal ultrasound is a highly informative non-invasive method. There is a need for further investigation of the management tactics of patients with endometrial pathology during menopause