Transvaginal color Doppler ultrasonography for prediction of pre-cancerous endometrial lesions

Arslan, Metin; Erdem, A.; Erdem, Mehmet; Yazici, Gürkan; Himmetoğlu, Özdemir; Gursoy, R

doi:10.1016/s0020-7292(02)00374-0

Cited by 20 publications

(21 citation statements)

References 26 publications

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“…Other researchers concluded that Doppler's velocity waveforms of uterine vessels performed with TVS are not beneficial enough to replace histopathological examination in the diagnosis of a neoplastic endometrial pathology. Nevertheless, it may be helpful in cases in which invasive procedures are difficult to perform and in the differentiation of a certain group of women less likely to develop endometrial carcinoma [19]. The results of the current study are promising.…”

Section: Discussionmentioning

confidence: 74%

Three-dimensional power Doppler ultrasound with a three-dimensional multislice view

El-Mekkawi¹,

Bahaa²,

Akl³

et al. 2015

Evidence Based Womenʼs Health Journal

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ObjectiveTo evaluate the efficacy of three-dimensional power Doppler (3DPD) and 3D multislice view in distinguishing between benign and malignant endometrial lesions in women with postmenopausal bleeding (PMB) and endometrial thickness of 5 mm or more. Study designThis was a diagnostic accuracy study. Patients and methodsWomen with PMB and an endometrial thickness of 5 mm or more on two-dimensional transvaginal sonography were evaluated by 3DPD before endometrial sampling to make a definitive histological diagnosis of endometrial lesions. Endometrial volume (EV), vascularization index (VI), flow index (FI), and vascularization-flow index (VFI) were calculated using Virtual Organ Computer-aided AnaLysis (VOCAL) software. 3D multislice view was used to increase the diagnostic accuracy of the above parameters (EV, VI, FI, and VFI) in the diagnosis of different endometrial lesions. The women included were divided into two groups: group 1 included 28 patients who had a histological diagnosis of endometrial carcinoma and group 2 included 32 patients who had a histological diagnosis of benign endometrial disorders. ResultsSixty women with PMB were finally analyzed; 32 (53.3%) women had benign endometrial lesions and 28 (46.7%) had endometrial malignancy. Women in group 1 tended to have significantly thicker endometrium (11.11 ± 3.61 vs. 5.78 ± 0.94 mm; P = 0.0001), larger EV (4.89 ± 3.53 vs. 2.22 ± 1.60; P = 0.001), and higher 3DPD flow indices (P = 0.0001) than those with benign endometrial lesions. There was a statistically significant difference between 3DPD and 3D multislice view, with increased vasculature in different planes in malignant cases than in benign cases (P = 0.0001). The best logistic regression models for predicting malignancy [i.e. the models with the largest area under the curve (AUC)] included endometrial thickness and VFI (AUC 0.984 and 0.884). ConclusionEven though histopathological examination of the endometrium is the gold standard for the final diagnosis or exclusion of endometrial malignancy, EV, 3DPD indices, and 3D multislice view are good diagnostic tools in predicting endometrial malignancy in women with PMB.

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Section: Discussionmentioning

confidence: 74%

Three-dimensional power Doppler ultrasound with a three-dimensional multislice view

El-Mekkawi¹,

Bahaa²,

Akl³

et al. 2015

Evidence Based Womenʼs Health Journal

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“…However, with the advance of high resolution ultrasound, studies on noninvasive evaluation of the uterine cavity have dramatically increased. Many studies showed thicker endometrium on grayscale sonography in neoplastic endometrial lesions [8][9][10][11]. However endometrial thickening on TVS is a nonspecific finding, therefore secondary tests are usually required to reduce false positive results.…”

Section: Discussionmentioning

confidence: 99%

“…A few authors have studied the role Doppler indices of genital vessels in differentiation of premalignant and malignant endometrial lesions. Some reported Doppler ultrasound to be useful but others limited to the values [6,8,11,14,19,20]. The characteristics of endometrial and myometrial vascularization on Doppler sonography were then searched.…”

Section: Discussionmentioning

confidence: 99%

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Contribution of spiral artery blood flow changes assessed by transvaginal color Doppler sonography for predicting endometrial pathologies

Kucur¹

2013

Diclemedj

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ÖZETAmaç: Endometrial patolojilerin değerlendirilmesinde transvajinal renkli Doppler ultrasonografi (RDU) ile spiral arter akım parametrelerinin katkısını araştırmak.Yöntemler: Anormal uterin kanama ile başvurmuş ve endometrial değerlendirme ihtiyacı olan 97 hastanın katıldığı prospektif gözlemsel bir çalışmadır. Endometrial kalınlık, yapı ve ekojenite kaydedildi. Transvajinal RDU ile spiral arter pulsatilite indeksi (Pİ) ve rezistif indeksi (Rİ) ölçüldü. Tüm olgulara endometrial örnekleme yapıldı. Ultrasonografik ve histopatolojik bulgular karşılaştırıldı. Bulgular: Histopatolojik tanılar; 39 olgu (%40,2) endometrial polip, 9 olgu (%9,3) endometrial hiperplazi, 10 olgu (%10,3) submuköz myom, 7 olgu (%7,2) endometrium kanseri, 32 olgu (%33) nonspesifik bulgular. Endometrial kanser olgularında spiral arter Pİ istatistiksel olarak yüksek anlamlılıkta düşük bulundu (p<0,01). spiral arter Rİ da malign histopatoloji olan olgularda anlamlı olarak düşük bulundu (p<0,05). Sonuç: Endometrial patolojiler endometrial spiral arter Doppler değişiklikleriyle ilişkilidir.Anahtar kelimeler: Spiral arter, Doppler ultrasonografi, endometrium. ABSTRACTObjective: To investigate the diagnostic value of blood flow measurements in spiral artery by transvaginal color Doppler sonography (CDS) in predicting endometrial pathologies. Methods:Ninety-seven patients presenting with abnormal uterine bleeding and requiring endometrial assessment were included in this prospective observational study. Endometrial thickness, structure and echogenicity were recorded. Pulsatility index (PI) and resistive index (RI) of the spiral artery were measured by transvaginal CDS. Endometrial sampling was performed for all subjects. Sonographic and hystopathologic findings were compared. Results:The histopathological diagnoses were as follows; 39 cases (40.2%) endometrial polyp, 9 cases (9.3%) endometrial hyperplasia, 10 cases (10.3) submucous myoma, 7 cases (7.2%) endometrium cancer, and 32 cases (33%) nonspecific findings. The spiral artery PI in endometrium cancer group was highly significantly lower than other groups (p<0.01). The spiral artery RI was also significantly lower in the patients with malignant histology (p<0.05). Conclusion:Endometrial pathologies are associated significantly with endometrial spiral artery Doppler changes.

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“…Por lo tanto existe una relación entre la resistencia de los vasos endometriales y la posibilidad de que este tejido tenga un componente maligno. A pesar de los aspectos teóricos y considerando de que existe un estudio demostrando una reducción de la resistencia de los vasos endometriales en pacientes con lesiones difusas, la contribución de la evaluación Doppler no mejora significativamente ni la sensibilidad ni la especificidad en la detección de hiperplasia o cán-cer endometrial, cuando éste es comparado con la medición endometrial realizada por ecografía transvaginal (8). Por lo tanto, la evaluación Doppler de la cavidad endometrial no tiene mayor contribución en el estudio de las pacientes peri y postmenopáusicas con sangrado uterino anormal.…”

Section: Métodos Basados En Imágenesunclassified

Eficiencia De Los Métodos Diagnósticos en El Estudio Del Sangrado Uterino Anormal en La Peri Y Postmenopausia

2008

Rev. chil. obstet. ginecol.

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RESUMENEl sangrado uterino anormal es un importante síntoma que puede indicar la presencia de cáncer o hiperplasia endometrial. El objetivo de este estudio es evaluar la eficiencia de los diversos métodos diagnósticos en pacientes peri y postmenopáusicas con sangrado uterino anormal y proponer una vía de manejo en estas pacientes. Diferentes métodos diagnósticos serán evaluados, incluyendo ecografía transvaginal, sonohisterografía, Doppler, resonancia magnética nuclear, biopsia por Pipelle, dilatación y curetage e histeroscopia. Está demostrado que la ecografía transvaginal tiene una alta eficiencia para el reconocimiento de lesiones difusas, mientras que sonohisterografía tiene una alta eficiencia para identificar lesiones focales. Por otro lado, la biopsia por Pipelle ha demostrado descartar patología difusa con una alta eficiencia. Se concluye que la mejor vía para el estudio de pacientes con sangrado uterino anormal es realizar una ecografía transvaginal y una histerosonografía en el mismo momento, seguido por una biopsia mediante Pipelle. Finalmente, puede ser sugerido que por esta vía es altamente probable que todos los casos de cáncer e hiperplasia endometrial puedan ser identificados. PALABRAS CLAVES: Sangrado uterino anormal, metrorragia, cáncer endometrial SUMMARYAbnormal uterine bleeding is an important symptom that can mean presence of endometrial cancer or endometrial hyperplasia. The aim of this study is to assess the effectiveness of selected diagnostic methods in peri and potmenopausal women with abnormal uterine bleeding, and to propose a way to manage in these patients. Different diagnostic methods are assessed, which include transvaginal ultrasonography, sonohysterography, Doppler technique, magnetic resonance images, biopsy by Pipelle, dilatation and curettage, and hysteroscopy. It is founded that ultrasonography has a high efficiency when it comes for identifying diffuse lesions, while sonohysterography has a high efficiency for identify focal lesions. On the other hand biopsy by Pipelle has demonstrated to rule out diffuse pathology with a high efficiency. It is concluded that the best way to manage patients with abnormal uterine bleeding by performing ultrasonography and sonohysterography at the same time followed by a Pipelle biopsy. Finally, it can be suggested that by this way it is highly probable that all cases with endometrial carcinoma and endometrial hyperplasia can be identified.

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Transvaginal color Doppler ultrasonography for prediction of pre-cancerous endometrial lesions

Cited by 20 publications

References 26 publications

Three-dimensional power Doppler ultrasound with a three-dimensional multislice view

Three-dimensional power Doppler ultrasound with a three-dimensional multislice view

Contribution of spiral artery blood flow changes assessed by transvaginal color Doppler sonography for predicting endometrial pathologies

Eficiencia De Los Métodos Diagnósticos en El Estudio Del Sangrado Uterino Anormal en La Peri Y Postmenopausia

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