Transvaginal color and pulsed Doppler sonography of the endometrium: a possible role in reducing the number of dilatation and curettage procedures.

Abstract

The objectives of the study were to establish color and pulsed Doppler sonographic characteristics of uterine vascularity in postmenopausal patients with pathologic endometrium in order to reduce the number of unnecessary diagnostic dilatation and curettage procedures. The prospective study involved 42 postmenopausal patients who were examined, prior to dilatation and curettage operation, with transvaginal color and pulsed Doppler sonography. Twenty patients had symptoms such as vaginal bleeding or clinically enlarged uterus and 22 postmenopausal women, from our screening group, were asymptomatic. Endometrial thickness (cut-off value of 8 mm), rates of visualization, and the density of uterine, myometrial (peritumoral) and endometrial (intratumoral) vessels were used, along with pulsatility and resistive indices of these vessels, to assess and correlate with endometrium pathology. Endometrial thickness was greater than 8 mm in all cases of endometrial carcinoma (14 of 14 cases), endometrial hyperplasia (eight of eight cases), and one endometrial polyp. In all cases of uterine myoma (nine cases) and in asymptomatic controls (11 subjects) the endometrium thickness was below 8 mm. Percentage of visualization of myometrial and endometrial vessels in cases of endometrial carcinoma was 93% and 43% respectively, which was significantly higher than for cases with benign endometrium (P < 0.05). RI and PI values of these studied vessels of endometrial carcinoma were significantly lower than those for endometrial hyperplasia (P < 0.05). In 80% of cases of endometrial carcinoma, dense vascularity was found in the myometrium (P < 0.01).(ABSTRACT TRUNCATED AT 250 WORDS)

A study of role of colour Doppler in evaluation of abnormal uterine bleeding at medicine and gynecology departments at a tertiary care institute of central India

“…Aleem et al 13 also found RI and PI were significantly less in the cases of endometrial hyperplasia. Alcazar et al 14 in his study found that the endometrial volumes were significantly higher in malignant conditions.…”

Endometrial Polyps: Symptomatology, Menopausal Status and Malignancy

“…The rationale for removing symptomatic polyps in patients is to rule out malignancy and obtain relief from associated symptoms. Some authors suggested that evaluation of tissue vascularization by color Doppler imaging may be useful in predicting malignant endometrial changes, as malignancy is associated with increased blood flow [14,15] . Similarly, low blood flow resistance is reported to be predictive of atypical endometrial polyps [16] .…”

Predicting Atypia Inside Endometrial Polyps

“…Since then, many reports have confirmed the ability of Doppler imaging to show aberrant neovascularization. [8][9][10]15 The ability to measure a flow waveform inside the stalk has permitted us to apply these principles to EPs. Using an arbitrary cutoff RI value of 0.5, we achieved good specificity.…”

“…7,8 Some studies suggest that color flow Doppler imaging may assist in the diagnosis of endometrial carcinoma, because blood flow is increased in malignant lesions. 9,10 Some EPs show color maps reflecting functional activity. The efficacy of the color map to assess functional activity in opposition to an atrophic pattern has been reported previously.…”