A Comparative Study Between Transvaginal Ultrasonography and MRI in Differentiation of the Underlying Causes of Postmenopausal Bleeding

Abstract

TVUSis better able to visualize and depict subtle abnormalities within the endometrium and to clearly define the endometrial-myometrial border. With high frequency vaginal transducers, the endometrium can easily be studied with regards to changes in the thickness. The thicker the endometrial lining on TVUS, the higher the risk of endometrial disease. Magnetic resonance imaging has a controversy role in diagnosis of uterine causes of PMB. Previous studies showed that the appearances of endometrial cancer, hyperplasia, and benign polyps overlap on MRI and its role is in the staging of biopsy confirmed endometrial cancer. MRI is more sensitive than transvaginal ultrasound or computed tomography in the detection of deep myometrial invasion and tumour spread beyond the uterus . In summary This large prospective implementation study shows:TVUS is a useful method for screening for endometrial abnormalities and we recommend its use in women with postmenopausal bleeding. Hence, unnecessary operations in postmenopausal women could be spared where the endometrium is ultrasonographically normal. While MRI is the superior diagnostic method to detect the myometrial invasion and cervical invasion. In other words, MRI can diagnose endometrial cancer in the early stage and may be a useful tool to guide the surgical approach, avoiding overtreating low-risk.