Study on non-invasive assessment indexes of endometrium after menopause
JIANG Juan1, REN Mu-lan2, WANG Yan2
1. Department of Gynaecology & Obstetrics, The Third Hospital of Wuhan, Hubei, Wuhan 430060, China; 2. Department of Gynaecology & Obstetrics, Zhongda Hospital, Southeast University, Jiangsu, Nanjing 210009, China
Abstract: Objective To explore non-invasive assessment indexes for state of endometrium after menopause. Methods Total 160 menopause women who had not undergone menopausal hormone treatment (MHT) were selected in menopause clinical of department of gynaecology & obstetrics at Zhongda Hospital, Southeast University from December 2012 to February 2014. They were classified into three groups, early menopause group (1-2 years), middle menopause group (3-5 years) and late menopause group (6-10 years). Menarche age, menopause age, duration of menopause, body mass index (BMI), waist to hip ratio (WHR) and Kupperman menopausal index (KMI) were recorded. Serum estradiol (E2) and follicle stimulating hormone (FSH) levels were determined. The endometrial thickness and Doppler flow spectrum parameters of uterine spiral artery including resistance index (RI), pulse index (PI) and peak systolic velocity (PSV) were measured via transvaginal ultrasonography. Uterine volume and ovarian volume were calculated. One-way ANOVA, nonparametric test and Spearman correlation analysis were used for statistical analysis. Results There was no significant difference on menarche age, menopause age, BMI and WHR in early menopause group, middle menopause group and late menopause group (P﹥0.05). KMI was significant higher in the early menopause group and middle menopause group ［(24.4±5.3) and (25.2±7.2)］ than late menopause group (15.9±8.8) (P﹤0.001). There was no significant difference on the serum levels of E2 and FSH in the three groups (P﹥0.05). The uterine volume of early menopause group and the late menopause group were respectively (37.2±16.2) vs (20.9±8.0) cm3. Ovarian volume were (1.9±0.8) vs (1.4±0.4) cm3. Uterine spiral artery PSV were 14.6±11.2 vs 8.0±3.1. The above three parameters of late menopause group were lower (P﹤0.05). The uterine spiral artery RI of early menopause group and late menopause group were 0.77±0.07 vs 0.85±0.05. Uterine spiral artery PI were 2.1±0.6 vs 3.1±0.7. The above two parameters of late menopause group were higher (P﹤0.05).The endometrial thickness of early menopause group, middle menopause group and late menopause group were (0.48 ± 0.20), (0.42 ± 0.13) and (0.44 ± 0.22) cm, respectively, with no significant difference (P﹥0.05). There were positive correlation (R = 0.466 and R = 0.544, both P﹤0.001) between duration of menopause and uterine spiral artery RI and PI; while negative correlation between duration of menopause and uterine spiral artery PSV (R=?0.395, P﹤0.001). Among the 24 patients with endometrium thickness over 0.5 cm, 16 (66.7%) of them were diagnosed as benign lesions, 8 (33.3%) diagnosed as non-benign lesions. All the 10 cases with endometrium thickness ≤0.5 cm were diagnosed as benign lesions. Conclusions Doppler flow spectrum parameters of uterine spiral artery including RI, PI and PSV are correlated with duration of menopause. They are expected to be effective indicators combined with endometrial thickness for postmenopausal endometrial noninvasive monitoring.
2017, Vol. 5 
