Detection of feeding artery improves the ultrasound diagnosis of endometrial polyps in asymptomatic patients

Abstract

Objective: To investigate whether transvaginal power Doppler imaging of the vascularity improves the ultrasound detection rate of endometrial polyps in symptomatic and asymptomatic patients. Study design: Forty-one patients with endometrial polyps confirmed by operative hysteroscopy and histologic examination. They were all examined with grey-scale and subsequent power Doppler enhanced ultrasound preoperatively according to the same protocol. Double layer endometrium and detailed endometrial morphology were described at grey scale scan. With power Doppler imaging pattern of endometrial vascularity. In the presence of a single feeding artery the ultrasound diagnosis of an endometrial polyp was made. Results: With grey-scale imaging 20 polyps (49%) were recognized, while the subsequent application of power Doppler diagnosed the remaining 21 polyps increasing the overall detection rate to 10% ( P < 0.01). The grey-scale detection rate for the polyp was 11/30 (0.37) in the asymptomatic patients and 9/11 (82%) in the symptomatic patients. No difference in endometrial thickness was observed. With power Doppler imaging, the detection rate for the feeding arteries was 97% (29/30) in the asymptomatic polyps and a similar 91% (10/11) in the symptomatic polyps. In the 21 polyps, where imaging of the vascularity was the only diagnostic marker, all but two were asymptomatic. Conclusion: Power Doppler enhanced ultrasound detection of the feeding vessels can be a simple, non-invasive and highly effective first line test for the diagnosis of endometrial polyps in asymptomatic patients.