To see the other types of publications on this topic, follow the link: Uterine bleeding.
Dissertations / Theses on the topic 'Uterine bleeding'
Create a spot-on reference in APA, MLA, Chicago, Harvard, and other styles
Consult the top 17 dissertations / theses for your research on the topic 'Uterine bleeding.'
Next to every source in the list of references, there is an 'Add to bibliography' button. Press on it, and we will generate automatically the bibliographic reference to the chosen work in the citation style you need: APA, MLA, Harvard, Chicago, Vancouver, etc.
You can also download the full text of the academic publication as pdf and read online its abstract whenever available in the metadata.
Browse dissertations / theses on a wide variety of disciplines and organise your bibliography correctly.
1
Fraser, Ian Stewart. "Pituitary, ovarian and uterine function in dysfunctional uterine bleeding." Thesis, University of Edinburgh, 1985. http://hdl.handle.net/1842/18204.
Full textAbstract:
This thesis describes a series of investigations of a rather poorly defined group of menstrual disturbances known as dysfunctional uterine bleeding (DUB). This condition is charact¬ erised by excessively heavy menstrual bleeding and, although commoner at ages 30-50 years, may occur at any time during rep¬ roductive life. The large published literature has been thorough ly reviewed and areas of ignorance highlighted. The investigations described have been devised to elucidate several aspects of pituitary, ovarian and uterine function in women of different ages with ovulatory and anovulatory DUB and compare these with normal women. All have raised questions requiring future study. The first section describes the use of a combination of isotope dilution techniques and direct sampling of ovarian venous blood and follicular fluid to study the ovarian blood flow and the ovarian secretion and metabolism of oestra diol and oestrone in women with normal menstrual function or DUB. In normal women 95% of circulating oestradiol was secreted by the developing follicle or corpus luteum. In women with DUB oestrogen metabolism was normal but the dynamics of oestrogen secretion was sometimes disturbed. In some cases multiple follicle growth and inappropriately high oestradiol secretion was observed. In the follicular phase most large follicles were functionally active and contained very high concentrations of oestradiol (>1250 ng/ml). Most adolescents with DUB are anovulatory and a very small proportion develop the more extreme endometrial changes of cystic glandular hyperplasia (CGH). Follow up of the group of 17 of these adolescents over 10 years revealed a high incidence of long term menstrual and reproductive disturbances. Detailed endocrine assessment over 3 cycles in 4 young women with DUB & CGH,and dynamic testing with oestrogen provocation and gonadotrophin-releasing hormone stimulation in a further 9 young women revealed a failure of positive oestrogen feedback as a cause of the anovulation. All exhibited prolonged follicular activity with, excessive oestradiol secretion. A careful study of perception of menstrual bleeding indi¬ cated that many women perceived their menstrual blood loss to be much heavier than objective measurements demonstrated. Only 38% of women with a convincing clinical history of menorrhagia had a measured blood loss of greater than 80 mis. These women also demonstrated some difficulty in assessing month to month and even day to day changes in blood loss volume. In a different group of 28 women it was found that only 36% of the menstrual discharge (range 1.6-81.7%) consisted of blood, and the remainder of the fluid is probably an endometrial transudate. This may contribute to difficulties in perception. The final section describes the development and application of two inert gas clearance techniques (with Krypton-85 and Kenon-J.33) for the measurement of endometrial blood flow (EBF) in women. The techniques have been validated by comparison with radioactive-labelled microspheres in sheep. Cyclical fluctua¬ tions in EBF were seen during the menstrual cycle with a pre¬ ovulatory peak, early luteal fall and gradual sustained rise up to the onset of menses. The pattern was similar in ovulatory DUB, while anovulatory women showed variable rates.
2
Brechin, Susan. "Abnormal uterine bleeding : mechanisms and management." Thesis, University of Aberdeen, 2001. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.251867.
Full textAbstract:
Luteal regression progesterone withdrawal, vasoconstriction of uterine vessels with ischaemia, hypoxia, necrosis are important events in the initiation of menstruation. Local factors, possibly released from endometrial inflammatory type cells, may also be involved. A family of enzymes, matrix metalloproteinases, identified within human endometrium are involved in tissue breakdown via actions on the extracellular matrix. Vasoactive substances, such as vascular endothelial growth factor, which stimulate angiogenesis are also present within the endometrium. Both factors may be important in initiation and regulation of menstruation, and have a role to play in the aetiology of abnormal uterine bleeding. Exogenous sex steroid hormones, oestrogen and progestogen, are commonly prescribed as contraceptives or hormone replacement therapy. Breakthrough bleeding is a common side-effect limiting their use. This thesis aims to identify local endometrial factors which may be involved in breakthrough bleeding in pre and post menopausal women exposed to hormone replacement and the levonorgestrel intrauterine releasing system. Expression of endometrial sex steroid receptors, matrix metalloproteinases (MMPs); and vascular endothelial growth factor (VEGF) will be identified. Menorrhagia, blood loss over 80 ml per cycle, leads to significant morbidity but is rarely measured out with clinical trials. Endometrial gland apoptosis is increased in women with such subjectively heavy losses. This thesis will identify if this increase is also seen in women with objectively measured menorrhagia when the endometrium is otherwise histologically normal. The management of women with aberrant patterns of uterine bleeding is based on endometrial assessment. This thesis will look particularly at a new method of endometrial sampling, the Tao Brush compared to the gold standard outpatient sampling device, the Pipelle. A clearer understanding of the role of these local control mechanisms, an improved ability to identify women with heavy blood losses and better sampling methods will allow rational and effective management of women with abnormal uterine bleeding.
3
Wood, David L. "Abnormal Uterine Bleeding, Amenorrhea and PCOS." Digital Commons @ East Tennessee State University, 2017. https://dc.etsu.edu/etsu-works/5172.
Full text
4
Bakour, Shagaf Haj. "Evaluation of ambulatory diagnosis of abnormal uterine bleeding." Thesis, University of Birmingham, 2003. http://etheses.bham.ac.uk//id/eprint/42/.
Full textAbstract:
In the ambulatory assessment of women with abnormal uterine bleeding, the main aim is to reach a diagnosis and thereby allow appropriate treatment. Excluding endometrial pathology, particularly carcinoma and hyperplasia, is of paramount importance. However there is no consensus as to which set of investigations should be used (hysteroscopy, ultrasonography and endometrial sampling). There is a lack of good quality research evidence on the accuracy of the various diagnostic tests in predicting endometrial lesions. This dearth of relevant evidence prompted the research presented in this thesis to address and answer the following research questions: • What is the accuracy of outpatient miniature hysteroscopy / ultrasonography in the identification of premalignant and malignant endometrial lesions? • What is the relative significance of hysteroscopic and ultrasonographic evidence of endometrial atrophy in relation to an insufficient sample on outpatient endometrial biopsy? • What is the risk of premalignant and malignant pathology among endometrial polyps? What is the significance of various risk factors associated with endometrial polyps? • What is the feasibility of multivariable analysis to evaluate combinations of diagnostic tests in the diagnosis of endometrial disease? Findings and Conclusions Positive hhysteroscopy is accurate in ruling in endometrial cancer and hyperplasia (the LR was 51.1 (95% CI 7.9-326.9). Using endometrial thickness >4mm at ultrasound scan, ultrasound is accurate in ruling out endometrial cancer and hyperplasia (the LR was 0.14 (95%CI 0.02-0.64). Insufficient sample on endometrial biopsy was more common among cases with hysteroscopic finding of endometrial atrophy (adjusted OR= 4.79, 95% CI 1.05-21.91, p=0.04) and less common among cases with sonographic endometrial thickness above 5mm (adjusted OR=0.19, 95% CI 0.07-0.53, p=0.001). Therefore insufficient sample may be considered a substitute to absence of pathology provided the hysteroscopic and sonographic endometrial assessment is consistent with endometrial atrophy. Hyperplasia was more frequent in endometrial specimens with polyps than in those without (9.7% vs 4.8%, OR=2.1, 95% CI 0.85-5.2), but the rate of carcinoma in the two groups was not statistically different (4.8% vs 3.2%, OR=1.5, 95% CI 0.46-5.0). Tamoxifen treatment was associated with endometrial polyps (adjusted OR= 8.16, 95% CI 2.01-33.2, p=0.003) but hormone replacement therapy was not (adjusted OR=1.35, 95% CI 0.65 – 2.81, p=0.42). The true clinical value of a test lies in the added information over and above what was already known from the history and examination. It is feasible to develop a stepwise multivariable analytic approach to explore the added value of tests (hysteroscopy or ultrasonography) over and above history when predicting endometrial hyperplasia or cancer. This analytic strategy needs to be applied in larger datasets to draw clinical conclusions.
5
Tsysar, Y. V. "Genetic predictors of uterine bleeding development in adolescent girls." Thesis, БДМУ, 2020. http://dspace.bsmu.edu.ua:8080/xmlui/handle/123456789/17630.
Full text
6
Biswas, Shivhare Sourima. "Investigation of uterine blood vessel development in heavy menstrual bleeding." Thesis, University of Newcastle upon Tyne, 2015. http://hdl.handle.net/10443/3069.
Full textAbstract:
Heavy menstrual bleeding (HMB) affects 30% of women of reproductive age, accounting for two-thirds of all hysterectomies. 50% HMB cases are unexplained and current treatment options often compromise fertility. Understanding the mechanisms underlying HMB is therefore critical to delineate potential pathways for therapeutic intervention. Previous studies suggested structural and functional roles for endometrial blood vessels in the pathogenesis of HMB. Endothelial cells (ECs) are associated with growth and formation of blood vessels; extracellular matrix (ECM) provides the framework for maintaining vascular structure, while vascular smooth muscle cell (VSMC) differentiation regulates blood flow and pressure. Altered endometrial vascular maturation is seen in recurrent miscarriage in association with increased uterine natural killer (uNK) cell number and variation in endometrial angiogenic growth factor (AGF) expression, but these processes have not been extensively studied in HMB. This study aimed to assess vascular maturation and AGF expression in HMB and investigate some of their effects in vitro. A study of VSMC differentiation revealed reduced endometrial calponin expression, suggesting a dysfunctional vascular contraction mechanism in HMB. This was associated with increased osteopontin expression, supporting previous evidence of regulation of vascular calponin expression by osteopontin. Endometrial collagen IV expression was lower in HMB, reflecting weaker vascular structure and definition. An altered pattern of uNK cell density in HMB may reflect altered in situ differentiation and or proliferation, which could impact vascular development and/or endometrial preparation for menstruation. VSMCs showed decreased endometrial expression of PDGFRα and TGFβRI, highlighting altered state of VSMC differentiation and potentially dysregulated endometrial vascular development in HMB. Furthermore, preliminary results indicated that PDGFBB helped to maintain EC ‘honeycomb’ structures, while anti-PDGFBB or TGFβ1 treatment decreased their numbers in vitro. Collectively, this study has highlighted key alterations in blood vessels in HMB, and established an in vitro model for future functional studies of blood vessel development.
7
Bennett, Alexandria. "Cost-effectiveness of an Outpatient Uterine Assessment and Treatment Unit in Patients with Abnormal Uterine Bleeding." Thesis, Université d'Ottawa / University of Ottawa, 2019. http://hdl.handle.net/10393/39473.
Full textAbstract:
Abnormal uterine bleeding (AUB) is one of the most common presenting complaints in our medical system with up to 30% of females affected by this condition. The current evaluation and management of AUB often requires multiple lengthy visits to both general practitioners and specialists. Advances in endoscopic technology have allowed clinicians to diagnose and treat women presenting with AUB in a single-visit within an outpatient uterine assessment and treatment unit (UATU). Unfortunately, the UATU is not the standard of care with very few locations in Canada providing this type of service. This thesis project aimed to synthesize data pertaining to efficacy and safety as well as to evaluate the cost-effectiveness of a UATU service model compared to usual care in diagnosing and treating AUB.
To address the main aim for this thesis project, the first manuscript focuses on the hysteroscopic procedures that may be offered in a UATU. The manuscript includes a systematic review that synthesizes outcome measures surrounding efficacy, patient safety, and cost data of outpatient hysteroscopy compared to hysteroscopy performed in the operating room. The second manuscript is a cost-effectiveness modelling study that compares cost and effectiveness outcomes, including time to diagnosis and time to treatment of a UATU versus usual care for women who present with AUB. Data used to populate the cost-effectiveness model were obtained from a retrospective review of patient charts and the published literature.
The systematic review found no statistically significant difference in the safety, efficacy, or patient tolerability between outpatient and intraoperative hysteroscopy procedures. This review helps provide further support for performing procedures outside of a traditional operating room without increasing patient harm or compromising efficacy. However, given the current available evidence and limited number of studies, findings should be interpreted with caution.
The cost-effectiveness analysis found that a UATU is cost-effective when compared to usual care in diagnosing and treating patients who present with AUB. These two studies combined provide evidence to support that the UATU has the potential to improve gynecologic care by reducing wait-times to receiving diagnosis and treatment and to lower overall costs to the health care system.
8
Bain, Christine. "The investigation and treatment of abnormal uterine bleeding in the premenopausal woman." Thesis, University of Aberdeen, 2002. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.247762.
Full textAbstract:
The research described in this thesis attempts to rationalise aspects of secondary care for premenopausal women with abnormal uterine bleeding, in particular investigation and assessment of a new method of endometrial ablation. The work was performed in a gynaecology unit with an established research record in endometrial ablative methods. The hospital is the main referral centre for women with menstrual disorders, enabling a centralised and stable population to be available. Chapter 1 outlines the past and present methods for the investigation and surgical treatment of abnormal uterine bleeding. Epidemiological factors for abnormal menstrual loss are discussed, as well as aetiology and the development of clinical evaluation. The equipment requirements for both transcervical resection of the endometrium (TCRE) and microwave endometrial ablation (MEATM) are described with a review of the literature to date on endometrial ablation. Chapter 2 presents a randomised comparative study of outpatient hysteroscopy and endometrial biopsy with endometrial biopsy alone for abnormal uterine bleeding. Outpatient hysteroscopy was successfully performed in almost 85% of women randomised to this procedure compared to 92% successfully receiving an endometrial biopsy alone. Hysteroscopy was found to be acceptable and viewed as a reassuring investigation. However, there was no difference in clinical outcomes between the two groups. Chapter 3 describes the subjects and methods used in a prospective randomised trial comparing MEATM with TCRE. Operative details and outcomes at one year are presented. MEATM was found to be a significantly faster endometrial ablative method than TCRE. The postoperative stay was less with MEATM, though not significantly and analgesic requirements were low in both groups. Satisfaction and acceptability rates with treatment were equivalent.
9
Сміян, Світлана Анатоліївна, Светлана Анатольевна Смиян, Svitlana Anatoliivna Smiian, Яна Семенівна Жерновая, Яна Семеновна Жерновая, Yana Semenivna Zhernovaia, Петр Семенович Вержанский, Петро Семенович Вержанський, and Petro Semenovych Verzhanskyi. "Диагностика и лечение гиперпластических процессов эндометрия с сопутствующей внутриматочной патологией." Thesis, Изд-во СумГУ, 2005. http://essuir.sumdu.edu.ua/handle/123456789/6939.
Full text
10
Pinion, Sheena Barbara. "Hysteroscopic surgery as an alternative to hysterectomy in the treatment of dysfunctional uterine bleeding." Thesis, University of Edinburgh, 1994. http://hdl.handle.net/1842/26853.
Full textAbstract:
The basis of this thesis is a prospective randomised trial comparing hysterectomy (n=99) with two methods of hysteroscopic surgery, endometrial laser ablation (n=53) and transcervical resection of the endometrium (n=52), in the treatment of dysfunctional uterine bleeding. The main outcome measures were efficacy in the relief of menstrual and related symptoms, operative complication rates, postoperative recovery, the effect of treatment on other symptoms, on psychosocial morbidity, and patient satisfaction. In the hysterectomy group, all women were amenorrhoeic at 12 months; in the hysteroscopy group, 93 (97%) were either amenorrhoeic or had light menstrual loss, although 32 women required a second procedure to achieve this status. At 12 months 13 (15%) of the hysterectomy group and 46 (58%) of the hysteroscopy group had continuing cyclical abdominal pain, although dysmenorrhoea improved in the majority. Major operative complications were rare in all groups, but minor morbidity, principally infection, was significantly more common following hysterectomy (difference 32%, 95% CI 20-44%, P<.001). There were major differences in postoperative recovery, with median time to self-reported recovery being two to three months in the hysterectomy group compared with two to four weeks in the hysteroscopy group (P<.0.001). Premenstrual symptoms improved in both groups and, although significantly less common in the hysterectomy group at six months, differences were no longer present at 12 months. Similarly there were no differences between the group in the incidence of urinary or bowel symptoms, dyspareunia or menopausal symptoms. Anxiety and depression were common preoperatively, but improved significantly postoperatively, with no difference between the groups at 12 months. Other aspects of psychosocial functioning were studied and found to be no different between the two groups. In conclusion, all but five women were satisfied with their outcome at 12 months.
11
Vom, Berg Anne Gabriele. "Diagnostic hysteroscopy alone is not sufficient for the diagnosis of patients with abnormal uterine bleeding /." [S.l.] : [s.n.], 2008. http://opac.nebis.ch/cgi-bin/showAbstract.pl?sys=000278546.
Full text
12
Hamoodi, Ibraheem. "Investigating the effect of uterine artery embolisation on the uterus of women with fibroids and heavy menstrual bleeding." Thesis, University of Glasgow, 2017. http://theses.gla.ac.uk/8114/.
Full textAbstract:
Uterine fibroids are common benign tumours in women. The effect they have can range from pressure symptoms and heavy menstrual bleeding to denying a woman a successful pregnancy. Despite the overall benign classification of fibroid, it is undeniable that the reduced quality of life these tumours cause may exceed the effect that some early stage gynecological cancers have on a suffering woman. There has been extensive research into treatments for fibroids however this has only resulted in a handful of worthy advances which are not proportionate to the impact these “benign” tumours have on a suffering woman. The mechanism for how fibroids affect the endometrium and cause heavy menstrual bleeding is understudied. Some of this research has pointed towards vascular endothelial growth factor and cyclooxygenase as potential mediators that change the perceived heaviness –amount and length- of a menstrual period in a woman with fibroids. Uterine artery embolisation (UAE) has emerged as a lesser invasive option and an alternative to surgery. The reported high technical success of the procedure independent of BMI and the short hospital stay and quick recovery has made it an attractive treatment modality. However, the mechanism of how it works is still not understood. Women with large variation in uterine size and fibroid number and size are undergoing this procedure without the full knowledge of how they will individually respond. This thesis aims to explore the mechanism of how UAE works by looking at the change in expression of VEGF, COX-2 & Ki67 and also the change in microvascular density of the endometrium post UAE. Our aim was to investigate how women with different sized fibroid uteri would respond to UAE and if DWI MRI had any advantages above standard MRI in predicting the outcome of UAE.
13
Abukhnjr, Salha Ali Muamer. "The role of vascular endothelial growth factor and other cytokines in the aetiology of heavy menstrual bleeding in women with uterine fibroids." Thesis, University of Glasgow, 2014. http://theses.gla.ac.uk/6501/.
Full textAbstract:
Introduction: The human endometrium undergoes cyclical changes of proliferation, differentiation and shedding. This cyclical process has been described as an inflammatory process. Menstrual abnormalities account for the morbidity of a large population of females in their reproductive age. Aberration in endometrial angiogenesis has been implicated in the mechanism of heavy menstrual bleeding (HMB). Although the precise mechanism for control the endometrial neoangionesis is not fully understood, vascular endothelial growth factor and other cytokines such as cyclooxygenases, prostaglandins, interleukin -8 and leukocytes have been implicated in both endometrial pathologies and angiogenesis dysregulation. In addition, heavy menstrual bleeding results from upregulation of the expression/synthesis of these local markers. Uterine fibroids are the most common benign tumor affecting the female reproductive tract. Heavy menstrual bleeding is the main presenting complaint of women with uterine fibroids. However, the mechanism by which uterine fibroids cause heavy menstrual bleeding has not been elicited yet. Therefore, the mechanism of action of different available treatments for this condition, including uterine artery embolisation is unclear. This thesis is based on the hypothesis that a) uterine fibroid changes the physiology of endometrium and we aimed to find out whether these markers work in a different way in heavy menstrual bleeding in those with uterine fibroids and those without., In addition I we wished to study whether uterine fibroid upregulate these local markers in heavy menstrual bleeding, whereas uterine artery emolisation down-regulates them. Methods: This thesis describes the use of endometrial samples, taken with a Pipelle sampler, collected from women with heavy menstrual bleeding both with uterine fibroids and also with normal uteri, to estimate the difference in the endometrial expression of the factors likely to be involved in the control of menstrual bleeding between the two groups. Results: The study found no differences between the expression of both either proteins or mRNA for the cytokines under investigation By using endometrium, myometrium and different types of fibroid tissue collected from women who had hysterectomies with the complaint of heavy menstrual bleeding, there was higher expression of VEGF, COX-2, PGE2 and IL8 proteins in fibroid than myometrial tissue. However, the level mRNA of expression for VEGF, COX-1, COX-2, IL8 and EP2 showed no differences between myometrial and fibroid tissue. In the same group, endometrial expression of these markers for women who had no hormonal therapy before operation compared with that for women who received gonadotropin releasing hormone agonists (GnRH), higher expression of VEGF mRNA in women who had GnRH agonists than those who had no any hormones. In fibroid tissue, GnRHdownregulated the expression of VEGF protein and other cytokines compared with those not on any hormonal therapy. In addition, the estimated serum levels of these factors, indicating a higher level of IL8 in the GnRH group than in the other group. Conclusion: It seems that theses markers play a role in HMB mechanism in both uterine fibroid and normal uteri group in same manner. In addition, they have a fundamental role in the growth of uterine fibroids as well.
14
Gonzalez, Sonia. "Assessing patient satisfaction levels following endometrial ablations in the treatment of abnormal uterine bleeding to determine effectiveness." Thesis, 2017. https://hdl.handle.net/2144/23801.
Full textAbstract:
OBJECTIVE: The objective of this study was to evaluate outcomes for women following endometrial ablations due to abnormal uterine bleeding (AUB). These outcomes included patient-reported quality of life, satisfaction with the procedure, and treatment failure. Women experiencing heavy/regular bleeding were compared with women experiencing heavy/irregular bleeding.
DESIGN: The study was designed as a prospective cohort study of women aged 18-55 years presenting to Women and Infants Hospital (WIH) in Providence, Rhode Island, for endometrial ablations due to AUB. Sixty-three participants in the study completed the Baseline Health Form, the Short Form-36 Health Survey (SF-36), and the Menstrual Bleeding Questionnaire (MBQ) upon enrollment. At the 3-month, 6-month, and 1-year follow-ups participants completed the SF-36 and the MBQ.
RESULTS: Baseline responses from the participants who were undergoing endometrial ablation found that 95.2% of women (n = 60) identified their periods as being heavy. From the total participants, 60.3% of women (n = 38) indicated their periods as being irregular. The SF-36 total score results demonstrate women with heavy/irregular bleeding experienced a greater negative impact in their quality of life. When broken down to the physical component score (PCS) and the mental component score (MCS) this difference, between women with heavy/regular bleeding and women with heavy/irregular bleeding, was minimized. Results from the MBQ revealed that women with heavy/irregular menstrual bleeding experienced a greater negative impact on their quality of life compared with women with heavy/regular bleeding.
DISCUSSION: Heavy bleeding is one of the defining factors in determining whether women seek further treatment for their menstrual bleeding, and when they do, they will usually attempt other therapies before pursuing surgery. The MBQ revealed a difference in quality of life between women with heavy/irregular bleeding and women with heavy/regular bleeding because this questionnaire measures bleeding and its impact on a woman’s life. The SF-36 total scores also showed a difference between heavy/irregular bleeding and heavy/regular bleeding. Breaking down the total SF-36 total score into the PCS and MCS minimized this difference. This questionnaire focused more on overall general health rather than bleeding and this focus may account for the smaller scoring differences among bleeding patterns.
CONCLUSION: Similar proportions of women experiencing heavy/regular and heavy/irregular bleeding pursue endometrial ablations as a treatment for AUB. The SF-36 demonstrated a greater burden on women’s general health when they have heavy/irregular bleeding. The MBQ provides a better measure to compare both bleeding patterns, aspects of bleeding, and demonstrates a more negative impact on quality of life for women with heavy/irregular bleeding.
15
Buhler, Coralie. "Clinical practice guidelines for the primary care management of menorrhagia with no known pathology/dysfunctional uterine bleeding in Manitoba." 2007. http://hdl.handle.net/1993/23102.
Full text
16
Moodley, Premla. "An evaluation of transvaginal ultrasound in the assessment of endometrial thickness in black South African patients presenting with postmenopausal uterine bleeding." Thesis, 2004. http://hdl.handle.net/10321/2038.
Full textAbstract:
Dissertation submitted in full compliance with the requirements for the Master's degree in Technology: Radiography, Durban Institute of Technology, Durban, 2004.The object of this study was to use Transvaginal ultrasound to evaluate the thickness of the endometrium to exclude endometrial abnormality in Black South African women with postmenopausal uterine bleeding. Transvaginal ultrasound is an excellent diagnostic method for assessing endometrial pathology. The study was carried out at the Gynaecological Ultrasound Department, King Edward VIII Hospital. The study included 76 Black women with postmenopausal uterine bleeding. The thickness of the endometrium was measured by Transvaginal ultrasound. The measurement included both endometrial layers (double-layer technique). The Transvaginal ultrasound measurement was compared with the histopathological diagnosis of the biopsy specimens. At the end of the investigation, findings obtained were 3.9% non-representative, 44.8% endometrial adenocarcinomas, 14.5% benign polyp, 3.9% chronic Endometritis, 17.1% benign endometrium, 5.3% endometrial hyperplasia, 9.2% atrophic endometrium, 3.9% myometrial invasion and 1.3% Malignant Mixed Mullerian Tumour. In this study, the thickness of the endometrial echo varied from 5mm to 35mm, with a mean of 18,2mm. When the thickness of the endometrial echo was compared with the histopathological results, the mean value for non-representative was 7.83mm, much lower than the thickness of an active endometrium (13.25mm). In cases with atrophic endometrium, the thickness ranged from 6mm to 30mm with a mean of 15.86mm. The mean value obtained for cases with endometrial adenocarcinoma was 20.32mm (range 11 to 35mm). The sensitivity, specificity and accuracy of Transvaginal ultrasound for detecting endometrial malignancy were 100% if the cutoff limit of 4mm was used In conclusion, this study using Transvaginal ultrasound demonstrated that a thickness limit greater than 8mm was considered in detecting malignancy. No malignant endometrium was thinner than 5mm. Therefore in women with postmenopausal uterine bleeding and an endometrium less than 4mm, it may be justified not to perform further investigations. Transvaginal ultrasound is a simple, well-tolerated safe and reliable method for identifying endometrial thickness in postmenopausal Black South African women.
M
17
Βλαχοκώστα, Αλεξάνδρα. "Ανάπτυξη τεχνικών επεξεργασίας ιατρικών δεδομένων και συστημάτων υποστήριξης της διάγνωσης στη γυναικολογία." Thesis, 2014. http://hdl.handle.net/10889/8537.
Full textAbstract:
Η αυτόματη επεξεργασία εικόνων του ενδομητρίου αποτελεί ένα δύσκολο και πολυδιάστατο πρόβλημα, το οποίο έχει απασχολήσει πλήθος ερευνητών και για το οποίο έχει αναπτυχθεί μεγάλος αριθμός τεχνικών.
Στην παρούσα διατριβή, παρουσιάζεται μια μεθοδολογική προσέγγιση, η οποία βασίζεται στη χρήση αλγορίθμων ψηφιακής επεξεργασίας και ανάλυσης εικόνων, για την αυτόματη εκτίμηση χαρακτηριστικών που περιγράφουν την αγγείωση και την υφή εικόνων του ενδομητρίου. Αφορμή της μελέτης αποτελεί ο ρόλος που διαπιστώνεται ότι διαδραματίζει η μεταβολή των τιμών των εν λόγω χαρακτηριστικών στην έγκαιρη διάγνωση των παθήσεων του ενδομητρίου.
Στα πλαίσια της διατριβής, υλοποιήθηκε κατάλληλη μεθοδολογία για τον υπολογισμό ενός συνόλου χαρακτηριστικών τόσο για υστεροσκοπικές εικόνες, όσο και για ιστολογικές εικόνες του ενδομητρίου. Ιδιαίτερη βαρύτητα δόθηκε στην προ – επεξεργασία των εικόνων προκειμένου να προκύψει βελτίωση της ποιότητας καθώς και ενίσχυση της αντίθεσης αυτών. Στη συνέχεια, ανιχνεύτηκαν τα σημεία που αποτελούν τους κεντρικούς άξονες των υπό εξέταση αγγείων με χρήση διαφορικού λογισμού για τις υστεροσκοπικές εικόνες και υπολογίστηκε ένα σύνολο χαρακτηριστικών μεγεθών που περιγράφουν την αγγείωση και την υφή των εικόνων τόσο για τις υστεροσκοπικές όσο και για τις ιστολογικές εικόνες. Τέλος, εφαρμόστηκαν κατάλληλοι αλγόριθμοι με σκοπό την κατηγοριοποίηση των υστεροσκοπικών και των ιστολογικών εικόνων και συγκεκριμένα τον διαχωρισμό των παθολογικών και των φυσιολογικών εικόνων του ενδομητρίου. Παράλληλα, χρησιμοποιήθηκε η ROC ανάλυση στην απεικόνιση και ανάλυση της συμπεριφοράς των εν λόγω κατηγοριοποιητών.Automatic analysis of the endometrial images is a difficult and multidimensional problem. For this reason, the number of papers and techniques regarding this issue is numerous. In this Thesis, a methodology is presented, based on advance image processing techniques in order to automatically estimate texture and vessel’s features in endometrial images. Motivation for the Thesis is the fact that the variation of the measurements of the specific features plays significant role in the seasonable diagnosis of endometrial disorders. Throughout this Thesis, an appropriate methodology is developed in order to estimate the features for the hysteroscopical and histological images of the endometrium. An important step is the pre – processing of the images in order to enhance the image quality and the image contrast. Then, the pixels that constitute the centerlines of vessels are detected by using differential calculus for the hysteroscopical images, only. Furthermore, the texture and vessel’s features in hysteroscopical and histological images are estimated. Finally, appropriate algorithms are applied in order to classify the hysteroscopical and histological images and distinguish pathological and normal endometrial images. ROC analysis is used in order to evaluate the discrimination power of the features that were estimated.