Transvaginal power Doppler sonography can discriminate between benign and malignant endometrial conditions in women with postmenopausal bleeding|
Aboul-Fotouh, Mahmoud El-Morsi; Mosbeh, Mohammed Hani; El-Gebaly, Ahmed Fathi & Mohammed, Ahmed Nageeb
Objective: To evaluate the role of transvaginal power Doppler sonography in differentiation
between benign and malignant endometrial conditions in women with postmenopausal
Setting: OB/GYN Dept., Suzan Mubarak University Hospital and Radiology Dept., Minia University
Hospital, Minia University, Minia, Egypt.
Study design: Prospective observational study.
Patients: Eighty patients with postmenopausal bleeding.
Intervention(s): Grey scale transvaginal sonography, power Doppler study of the endometrium
and endometrial-myometrial interface, and office hysteroscopy and the final diagnosis by histopathological
examination of hysteroscopic guided biopsy.
Results: Endometrial power Doppler signals were positive in 69 out of the eighty patients
(86.25%): 8 cases showed multiple vessel pattern -A- (10%); 19 cases with single vessel pattern -
B- (23.75%); 42 cases with scattered vessel pattern -C- (52.5%) while in the remaining 11 cases
(13.75%), no power Doppler signals were detected. The hysteroscopic findings were endometrial
polyp in 16 cases (20%), atrophic endometrium in 14 cases (17.5%), hyperplasic endometrium in
32 cases (40%), submucus fibroid in 6 cases (7.5%), cervical polyp in 3 cases (3.75%) and suspicious
endometrium for malignancy in 8 cases (10%). Hysteroscopy was more accurate in cases with intracavitary
masses (polyps and submucous fibroids) than power Doppler, but power Doppler had a
more predictive value for malignant endometrium.
Conclusion: Power Doppler blood flow mapping of the endometrium in women with postmenopausal
bleeding is useful to discriminate carcinoma from other endometrial pathologies.
Postmenopausal bleeding; Transvaginal sonography; Power Doppler sonography; Office hysteroscopy; Hysteroscopic guided biopsy