Ultrasonographic feature of endometrial lesions in child-bearing period women and the relationship with pathology

Abstract

Objective To investigate the relationship of ultrasonographic features and their pathologic basics in women of child-bearing period with abnormal uterine bleeding, and to explore the diagnostic ideas in detecting endometrial lesions. Methods A total of 149 women in childbearing age who had endometrial lesions with pathologically confirmed endometrial lesions, including 88 cases of endometrial hyperplasia, 41 cases of endometrial polyp, 20 cases of endometrial carcinoma, at Fuxing Hospital, Capital Medical University from October 2001 to September 2016 were selected. Ultrasound exams were performed on patients in early proliferative phase of menstrual cycle or within three days after vaginal bleeding stopped. We recorded patients′ age, measured sum diameters of length, width and thickness of uterine, mean thickness of endometrium and maximum diameter of polypoid lesions. We grouped the patients by pathologic results and compared ultrasound parameters between groups. The thickness of endometrium over 1.0 cm was considered as ″increased″. The pathologic exams also included ovarian structures. Results (1) There was no significant difference in the average age of patients with endometrial hyperplasia, endometrial polyps and endometrial cancer (P>0.05). (2) Ultrasonography: there was no statistically significant difference in the sum of the diameters of the uterus in the three groups (P>0.05); the thicker diameter of the uterine cavity in the intimal hyperplasia group was compared with the endometrial polyp group and the endometrial cancer group [(11.70±5.42) mm vs (10.59±3.83) mm vs (17.14±8.70) mm], the difference was statistically significant (F=9.779, P 0.05). Of the 88 cases of hyperplasia of intimal hyperplasia, 53 were polypoid, and the mean diameter of the polypoid uplift was compared with the endometrial polyp group [(17.13±10.45) mm vs (12.14±4.67) mm], the difference was statistically significant (t=3.112, P=0.002). The proportions of point and strip blood flow signals in 41 cases of endometrial polyps and 53 cases of polypoid hyperplasia were 75.61% (31/41), 41.51% (22/ 53). Of the 163 patients in the three groups, 63 patients had a uterine cavity echo of <10 mm (42.3%). (3) Pathological examination: 20 cases of endometrial cancer were endometrioid carcinomas, 11 cases of hysterectomies, 7 cases of well-differentiated endometrioid carcinoma, 3 cases of moderate differentiation, 1 case of poorly differentiated; at the same time, 8 cases of ovariectomy. In 7 cases, there were multiple atresia follicles, and one case was pure cyst. Of the 88 patients with endometrial hyperplasia, 77 were hyperplasia and hyperplasia, 1 had dysplasia, 11 had complicated hyperplasia, and 3 had dysplasia. Of the 41 cases of endometrial polyps, 33 were non-functional polyps, 3 were functional polyps, and in 4 cases of adenoid fibroid polyps, there was 1 case of canceration. Conclusion In the early stage of endometrial proliferation or within 3 days after vaginal bleeding cases, the uterine cavity echo thickness diameter ≥10 mm suggests abnormal endometrium; uterine cavity echo thickness diameter <10 mm, endometrial abnormalities cannot be excluded; dynamic monitoring of ovulation by ultrasound may indicate the presence or absence of risk factors for abnormal growth of the endometrium. Key words: Endometrium; Endometrial neoplasms; Ultrasonography