- Hyperplastic processes of endometrium in women with infertility: comparing the results of ultrasonographic and pathomorphological changes of the endometrium
Hyperplastic processes of endometrium in women with infertility: comparing the results of ultrasonographic and pathomorphological changes of the endometrium
HEALTH OF WOMAN. 2018.7(133):129–133; doi 10.15574/HW.2018.133.129
Kuzyk Yu. I. , Chornenka G.M.
Lviv national medical University named Danylo Galitsky
I. Horbachevsky Ternopil State Medical University of the Ministry of health of Ukraine
The objective: to find out the level of verification of endometrial hyperplastic processes (GPE) in women with uterine infertility based on the comparison of ultrasound and pathomorphological studies.
Materials and methods. 64 patients of reproductive age was performed ultrasonographic study and diagnostic endometrial biopsy.
Results. Three groups of GPE have been identified: polyps – 33 cases, hyperplasia –15, combination of glandular hyperplasia with endometrial polyp – 16. The endometrial polyps included: glandular – seven cases, glandular-fibrous with an advantage of the glandular component – 13, and glandular-fibrous with the advantage of the stromal component – 13. The accuracy of the verification of glandular polyps was 82%. Glandular-fibrotic polyps with an advantage of the glandular component were diagnosed in 82%. Glandular-fibrous endometrial polyps with the advantage of the stromal component were the most difficult for ultrasonic verification. The accuracy of their diagnosis was 50%. Such characteristics as nodular form, intramural position, increased echogenicity and absence of inclusions were the basis for erroneous diagnosis of uterine fibromyomas. Endometrial hyperplasia was verified at 97%. The remaining 3% were histologically diagnosed with endometrial polyposis, which were not established by ultrasound, and were considered as hyperplasia of the endometrium. Ultrasound diagnosis of the combination of endometrial hyperplasia and polyps reached 77%. The polyps on the background of endometrial hyperplasia appeared as fibromyomatous nodes. The determining role in correct diagnosis was played by hysteroscopy.
Conclusion. The comparison of ultrasound data and morphological evidence suggests high accuracy of GPE detection and morphological verification. However, in some cases GPE ultrasound does not precisely determine the nature of pathological changes. Therefore, the study of the pathomorphological features of remodeling of the endometrium in the GPE remains open and requires new promising approaches. One of them, based on certain pathomorphological changes in GPE, is the use of blood flow research, in particular transvaginal color doppler, which may allow to improve the accuracy of the diagnosis of GPE.
Key words: endometrial hyperplasia, endometrial polyp, endometrial hyperplasia, ultrasound diagnosis, pathomorphology, reproductive age.
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