Color Doppler and Transvaginal Sonography; Accuracy in the Diagnosis of Endometrial Pathologies in Women with Abnormal Uterine Bleeding: A Cross-sectional Study

Abstract

Introduction: Abnormal uterine bleeding (AUB) can occur at any age in a woman’s life, and it is more prevalent in the premenopausal age group. Although anovulation is the most prevalent endometrial cause, other major reasons include endometrial hyperplasia, endometrial adenomatous polyps and cancer. For patients of all ages, it is one of the most prevalent presentations in Gynecology OPDs. AUB has a major impact on health-related quality of life, necessitating quick intervention. AUB treatment is difficult without a good diagnosis. As a result, pre-menopausal and post-menopausal women with AUB must have a thorough examination to rule out endometrial cancer. Aim: To assess the role of transvaginal ultrasound and color Doppler tomography (CDTU) in irregular uterine bleeding and correlate these findings with histological diagnosis. Methodology: The present study included 92 individuals with abnormal uterine bleeding (AUB), in those TVS, and Color Doppler was used to evaluate the endometrial pathologies. Endometrium, uterine size and any uterine or adnexal disease were evaluated during the TVS. Spiral arteries of the endometrium and uterine arteries were studied for their vascular patterns. The RI and PI of the uterine artery were determined. For PI, a cutoff of 1.83 was used, while for RI, a cutoff of 0.81 was used. The results were then compared to endometrial histology. Results: According to TVS, (see Table 1) the most common causes of AUB were leiomyoma (15.2%), polyp (12%), PCOS (9.8%), adenomyosis (5.43%) and endometrial development (3.3%). The uterine indicators of RI (0.81) and PI (1.83) of the uterine artery by CDTU revealed 11 patients with probable cancer. For AUB M, the TVS with CDTU specificity and sensitivity was 100 percent and 90.77 percent, respectively. The positive predictive value was 45%, whereas the negative predictive value was 100%. Conclusion: The use of vascular impedance and color Doppler of the uterine artery and endometrial spiral arteries improves the diagnostic accuracy of TVS for the prediction of endometrial diseases. It makes screening for malignant and premalignant lesions easier.