The role of transvaginal elastosonography in the differential diagnosis of endometrial carcinoma and hyperplasia during post-menopausal period

Purpose: To utilize the aid of transvaginal (TV) elastosonography (ES) in the differentiation of endometrial hyperplasia and endometrium carcinoma (ca) and to compare these yields with the results of normal endometrium SE of post-menopausal patients. Material and methods: 136 patients with the complaints of postmenopausal hemorrhage and/or of the normal control TVUltrasonography (US) between February and October 2013 were included in this research. TV-elastosonography (ES)was performed under the samemonitor consecutivelywith the TV-US. Strain index (SI) was recorded for each patient, Kolmogorov–Smirnov test for Normal variables, Student’s t test, Kruskal Wallis Analysis of Variance test, Mann Whitney U Test with Bonferroni Correction was applied for pairwise statistics. Receiver Operating Characteristics (ROC) curvewasfitted inorder to characterize thegroupdifferences in terms of sensitivity and specificity scores. Results: The SI values of normal control group, endometrial carcinoma and hyperplasia groups were compared to each other statistically, no significant statistical differences between hyperplasia and control groups, but a significant statistical differencewas introduced for the endometrial carcinoma against these hyperplasia and control groups (p=0.000). In real-time ES; the scoring of elasticity patterns between endometrial ca and hyperplasia presented 81.3% sensitivity, 100% specificity and PPV, 70% NPV. Conclusion: Real time-elastosonography is a complementary semi-quantitative method compared to the other cross-sectional imaging methods, provides valuable information especially for the endometrial pathologies.