Three-dimensional ultrasonography and power Doppler for discrimination between benign and malignant endometrium in premenopausal women with abnormal uterine bleeding.

Mohamed El-Sharkawy,Mohamed Hammam,Akmal El-Mazny,Wafaa Ramadan,Aly Abdel-Hafiz,Dina Hatem,Adel Nada

doi:10.1186/s12905-016-0297-3

Abstract

BackgroundUltrasonography has been extensively used in women suspected of having a gynecological malignancy. The aim of this study is to evaluate the efficacy of 3D ultrasonography and power Doppler for discrimination between benign and malignant endometrium in premenopausal women with abnormal uterine bleeding.MethodsThis cross-sectional study included 78 premenopausal women with abnormal uterine bleeding scheduled for hysteroscopy and endometrial curettage. The endometrial thickness (ET), uterine artery pulsatility index (PI) and resistance index (RI), and endometrial volume (EV) and 3D power Doppler vascularization index (VI), flow index (FI), and vascularization flow index (VFI) were measured and compared with hysteroscopic and histopathologic findings.ResultsThe ET (P <0.001), EV (P <0.001), and endometrial VI (P <0.001) and VFI (P = 0.043) were significantly increased in patients with atypical endometrial hyperplasia and endometrial carcinoma (n = 10) than those with benign endometrium (n = 68); whereas, the uterine artery PI and RI and endometrial FI were not significantly different between the two groups. The best marker for discrimination between benign and malignant endometrium was the VI with an area under the ROC curve of 0.88 at a cutoff value of 0.81 %.Conclusion3D ultrasonography and power Doppler, especially endometrial VI, may be useful for discrimination between benign and malignant endometrium in premenopausal women with abnormal uterine bleeding.

Highlights

Ultrasonography has been extensively used in women suspected of having a gynecological malignancy
The aim of this study is to evaluate the efficacy of 3D ultrasonography and power Doppler for discrimination between benign and malignant endometrium in premenopausal women with abnormal uterine bleeding
Of the 78 women included in the study, 68 (87 %) had benign endometrium and 10 (13 %) had malignant endometrium

Summary

Introduction

Ultrasonography has been extensively used in women suspected of having a gynecological malignancy. The aim of this study is to evaluate the efficacy of 3D ultrasonography and power Doppler for discrimination between benign and malignant endometrium in premenopausal women with abnormal uterine bleeding. Abnormal uterine bleeding is usually the first symptom; appropriate evaluation of women with premenopausal or postmenopausal bleeding will allow for early diagnosis of endometrial carcinoma and the best opportunity for cure [2]. Ultrasonography has been extensively used in women suspected of having a gynecological malignancy, especially in ovarian [3] and endometrial [4] cancer. Transvaginal ultrasonography is considered the initial imaging procedure for evaluating abnormal vaginal bleeding due to its ability to depict endometrial pathology, its widespread availability, and its excellent safety profile and cost effectiveness [5]. 3D power-Doppler ultrasonography allows a 3D reconstruction of the vascular network and

Objectives

Methods

Results