What is the first-line imaging modality for evaluating AUB?

What is the first-line imaging modality for evaluating AUB?

• A. Transvaginal ultrasound
• B. Pelvic MRI
• C. CT scan
• D. Abdominal X-ray

Answer: (A)

The best initial test for evaluating abnormal uterine bleeding is transvaginal ultrasound. It gives a quick, high-resolution view of the uterus and adnexa, allowing you to identify common structural causes such as fibroids, polyps, or adenomyosis and to assess endometrial thickness. This information helps determine whether endometrial sampling is needed, especially in postmenopausal bleeding or when pathology is suspected. It’s noninvasive, widely available, and free from radiation, making it ideal as the first step. Pelvic MRI can provide more detailed tissue characterization and is useful if ultrasound is inconclusive or if complex pathology is suspected, but it isn’t the initial test due to cost, accessibility, and longer imaging time. CT scan exposes patients to radiation and is less sensitive for evaluating the endometrium and uterine lining. Abdominal X-ray isn’t helpful for assessing uterine causes of bleeding.

The best initial test for evaluating abnormal uterine bleeding is transvaginal ultrasound. It gives a quick, high-resolution view of the uterus and adnexa, allowing you to identify common structural causes such as fibroids, polyps, or adenomyosis and to assess endometrial thickness. This information helps determine whether endometrial sampling is needed, especially in postmenopausal bleeding or when pathology is suspected. It’s noninvasive, widely available, and free from radiation, making it ideal as the first step.

Pelvic MRI can provide more detailed tissue characterization and is useful if ultrasound is inconclusive or if complex pathology is suspected, but it isn’t the initial test due to cost, accessibility, and longer imaging time. CT scan exposes patients to radiation and is less sensitive for evaluating the endometrium and uterine lining. Abdominal X-ray isn’t helpful for assessing uterine causes of bleeding.