B-mode, color Doppler and three-dimensional ultrasound in the assessment of endometrial lesions

Abstract

Transvaginal sonography enables detailed evaluation of endometrial thickness and texture. Color Doppler studies become a valuable diagnostic tool in differentiating benign from malignant endometrial lesions. Three-dimensional ultrasound improves visualization of the uterine cavity, providing simultaneous display of the coronal, sagittal and transverse sections. The measurement of endometrial volume seems to be superior to the evaluation of endometrial thickness as a diagnostic test for detection of endometrial cancer in symptomatic postmenopausal women. Increasing volume size is associated with the severity or higher grade of endometrial carcinoma, and also with progressive endometrial invasion. Three-dimensional ultrasound with the aid of power Doppler imaging may have an additional role in predicting the depth of myometrial invasion in patients with endometrial malignancy. The ability to examine neovascular areas within the endometrium and myometrium, at the same time as morphological and volume evaluation, increases diagnostic accuracy. In conclusion, color Doppler and three-dimensional ultrasound studies may potentially reduce the number of invasive procedures such as dilatation and curettage with a considerable decrease of both the potential risks and economic costs.