停經後陰道出血的超音波評估

The use of transvaginal ultrasound in the evaluation of women with postmenopausal bleeding

停經後的陰道出血，是一個令人緊張但卻是在臨床上非常常見的婦產科病況。傳統上，除了排除子宮內膜癌外且找到其他可能的出血的原因，總是無法讓病人或醫師放心。據不同的研究發現，在此些停經後出血的婦女中，約有1%到14%的婦女，最後被診斷為子宮內膜癌。除了臨床病史的評估，例如肥胖、高血壓、糖尿病、低產次，或者不當的使用賀爾蒙藥物外，可能需要有強而有力且方便而且便宜的工具來輔助我們在臨床上的評估及判斷。本文就簡介這個有效的工具—經陰道超音波的檢查。

Postmenopausal bleeding is a common disorder of women, which causes anxiety of both patient and physician, if we cannot exclude the possibility of endometrial cancer. Based on the literature review, the final diagnosis of endometrial cancer occurred in 1~14% of these women with postmenopausal bleeding. Although the detailed history of the patients is important, including obesity, hypertension, diabetes mellitus, low parity and the use of unopposed estrogen, a powerful but convenient and low-cost tool is welcome to aid the clinical evaluation. Among these, transvaginal ultrasound is worthy of being discussed, because of the extremely high negative predictive value of a thin distinct endometrial echo when adequately visualized.