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Abstract To analyze the value of ultrasound real-time shear wave elastrography (SWE) for diagnosing endometrial lesions of postmenopausal women. Methods: The clinical data of 230 postmenopausal women with endometrium ≥5mm from March 2017 to May 2020 were selected in this study. According to endometrial biopsy pathological results, these women were divided into group A (women with benign lesion of endometrium), group B (women with atypical hyperplasia of endometrium), and group C (women with malignant lesion of endometrium). The eaxaminations of two-dimensional ultrasound, three-dimensional ultrasound, and SWE were performed on all these women in the three groups to obtain blood flow classification by two-dimensional ultrasound, the values of blood flow VI, FI, VFI by three-dimensional ultrasound, and the values of Emax and Emean by Young's modulus. The possible factors affecting endometrial lesions by ultrasonic blood flow examination were analyzed. The predictive value of Emax and Emean for endometrial lesions was explored. Results: Age and the endometrial thickness of the women in group A, group B, and group C had increased gradually. The BMI value of the women had no significant different between group C and group B, but which of the women in group C and group B were significantly higher than that of the women in group A (all P＜0.05). The values of Emean and Emax of the women in group A, group B, and group C had increased gradually. The composition ratio of grade 2 and 3 of blood flow of the women in group A, group B, and group C had increased gradually. The composition ratio of grade 0 and 1 of blood flow of the women in group A, group B, and group C had decreased gradually. The values of blood flow VI, FI and VFI by three-dimensional ultrasound of the women had no significant difference between group C and group B, but which of the women in group C and group B were all significantly higher than those of the women in group A (all P＜0.05). Age, body mass index, endometrial thickness, blood flow grade 3, and Emean and Emax abnormality were all the independent risk factors of endometrial progression of the women (P＜0.05). Emax and Emean values had predictive value for endometrial malignant lesions (P＜0.001), and which area under the curve were 0.813 and 0.826, respectively. Conclusion: SWE has good diagnostic value for endometrial malignant lesions of postmenopausal women.
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