Role of Colour Doppler and Transvaginal Sonography for diagnosis of endometrial pathology in women presenting with Abnormal Uterine Bleeding

Abstract

Introduction: Transvaginal Sonography has emerged as important modality in investigating AUB, but it cannot diagnose endometrial pathology in absence of histopathology of endometrium. Addition of Color doppler (CDTU) to TVS can help in diagnosis by evaluation of blood flow through vascular patterns and Uterine artery indices. Objective: To evaluate the role of Trans vaginal Ultrasonography and Colour Doppler (CDTU) in abnormal uterine bleeding and correlating them with histopathological diagnosis. Methods: TVS and Colour Doppler were performed in 70 patients with AUB. TVS included evaluation of endometrium, size of uterus, any uterine or adnexal pathology. Vascular pattern of Spiral arteries of endometrium, and uterine arteries was analysed. Uterine artery indices (RI and PI) were calculated. 1.83 was taken as cut off for PI and 0.81 was taken as cut off for RI. The results were then compared with histopathology of endometrium. Results: On TVS, the causes of AUB were Leiomyoma in 17.1%, polyp in 10%, PCOS in 8.5%, Adenomyosis in 5.7%, and Endometrial growth in 2.8%. 11 patients had suspected malignancy by uterine indices of RI ( and PI ) were calculated. 1.83 was taken as cut off for PI and 0.81 was taken as cut off for RI. The results were then compared with histopathology of endometrium. Results: On TVS, the causes of AUB were Leiomyoma in 17.1%, polyp in 10%, PCOS in 8.5%, Adenomyosis in 5.7%, and Endometrial growth in 2.8%. 11 patients had suspected malignancy by uterine indices of RI (<0.81 ) and PI (<1.83) of uterine artery by CDTU. Specificity and Sensitivity of TVS with CDTU for AUB M was 100% and 90.77% respectively. Positive predictive value was 45.45% and negative predictive value was 100%. Conclusion: Colour Doppler of the uterine artery and endometrial spiral arteries with vascular impedance, improves the diagnostic accuracy of TVS for the prediction of endometrial pathologies and facilitates in screening for malignant and premalignant lesions.