The major role of ultrasound in the evaluation of abnormal uterine @entity548 , other than that occurring during pregnancy, is in postmenopausal @entity1 . Because @entity548 can be the presenting symptom of @entity1204 , any @entity1 with this symptom should be evaluated to diagnose or exclude @entity189 . Over the last two decades, the role of ultrasound in the evaluation of @entity548 has changed markedly, from little or no role in 1990 to a major role today. In the intervening years, numerous studies have shown that ultrasound is at least as sensitive as endometrial biopsy for @entity1204 and that ultrasound can reliably exclude @entity5 without the need for biopsy in some @entity1 with @entity548 . In particular, numerous studies have shown that @entity1 with an endometrial thickness of 4 mm or less have an extremely low likelihood of @entity1204 and thus do not need to undergo endometrial biopsy. Ultrasound can also help in the selection of an appropriate biopsy technique. In a @entity1 with @entity548 and a thick endometrium, a sonohysterogram can determine whether the endometrium is diffusely thick or has focal areas of thickening. With diffuse thickening, a blind endometrial biopsy is appropriate. When there are one or more focal areas of thickening, hysteroscopic biopsy is likely to be the better choice. We present two clinical algorithms, either of which is an acceptable approach to the use of ultrasound and/or endometrial biopsy in @entity1 with @entity548 : the "ultrasound-first" approach and the "biopsy-first" approach.

Diagnosis of abnormal uterine XXXX with imaging.

@entity1 :: ('9606', 'Species') :: ['women', 'woman'] @entity1204 :: ('MESH:D016889', 'Disease') :: ['endometrial cancer'] @entity548 :: ('MESH:D006470', 'Disease') :: ['postmenopausal bleeding', 'bleeding'] @entity5 :: ('MESH:D009369', 'Disease') :: ['cancer'] @entity189 :: ('MESH:D002277', 'Disease') :: ['carcinoma']
@entity548 :: (MESH:D006470,Disease) :: ['bleeding']
