| ObjectiveTo compare the diagnostic value of endometrial thickness and volume measurements by VOCAL in patients with postmenopausal bleeding. Three - dimensional (3D) ultrasound may display endometrial in coronal plane, which gives much more messages. The measurement of endometrial volume by 3D ultrasound is more sensitive and has a high positive predict value in diagnosing endometrial carcinoma with postmenopausal patients. It is simple to use VOCAL and the volume calculation from VOCAL is both reliable and valid. VOCAL provides a reproducible method for the estimation of endometrial volume and can be used in clinic. 2D ultrasound can only provide messages on planes which must be imaged by doctor before the diagnoses were made. 2D ultrasonography has less consistency because of the different experience of the doctor. In addition, solely measuring endometrial thickness may miss the endometrial messages of corn , which is the place that endometrial carcinoma usually happens. Endometrial thickness measured by 2D - ultrasound can distinguish the endometrial without diseases with one has diseases, but it cant make the difference between benign and malignant diseases of endometrial. This test try to distinguish the malignant diseases with benign diseases by measuring endometrial volume. This paper use the standard statistics method admitted by international to analysis the 2D -sonography measuring endometrial thickness and 3D - ultrasonography's VOCAL measuring endometrial volume in order to evaluate the diagnostic value of the twodiagnostic methods for endometrial carcinoma of postmenopausal.METHODSA total of 93 patients who were postmenopausal for between 1 years and 27 years and complained of vaginal bleeding were recruited into the study. Their mean age was 59 years. All patients were examined by ultrasound prior to endo-metrail biopsy or dilatation and curettage performed. All patients underwent a transvaginal ultrasound scan with a 7. 5 MHz probe with three - dimensional facility. Once B - mode examination had been completed, three - dimensional volumes were recorded. The volumes were generated by the automatic rotation of the mechanical transducer. Volumes were then analyzed, with the use of computer-generated planar reformatted sections. Following the scan, all patients underwent endometrial biopsy or dilatation and curettage. According to the results of pathology, endometrial carcinoma was diagnosed in 33 patients and endometrial benign diseases were diagnosed in 30 patients. Also we have 30 cases normal women as the control. The Kruskal - Wallis rand test was used to calculated whether differences in data were significant. Receiver operating characteristic curves were used to compare the diagnostic performance of endometrial thickness and volume measurements for the diagnosis of cancer.RESULTSThe endometrial thickness and volume were both significantly lower in patients with benign pathology. The thickness was similar in patients with benign and malignant pathology. However, the endometrial volume in malignant pathology was significantly higher than the volume in patients with benign pathology. There was an overlap in the endometrial thickness between normal cases and those with benign and malignant pathology. The area under curve of volume is 0. 892 and the AUC of thickness is 0. 679. The difference between them is significant. Comparison of receiver operating characteristic curves for the thickness and volume measurements showed that the latter was more sensitive for the diag-... |
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