To What Extent Doppler Transvaginal Sonography can be Reliable in Pre and Postmenopausal Women with Abnormal Uterine Bleeding?

Abstract

The current study was to assess the efficacy of gray scale and power Doppler transvaginal ultrasound in management of patients referred with abnormal uterine bleeding (AUB). This prospective analytical observational cross-sectional study performed from 2015 to 2016 to evaluate 120 women (15 premenopausal and 85 postmenopausal) with abnormal uterine bleeding in Alzahra hospital, Isfahan, Iran. The patients were classified according the AUB diagnosis to endometrial atrophy, hypertrophy, cancer and polyp. Dilatation and curettage (D&C) in polypoid lesions, focal thickening, mass and the endometrial pipelle sampling, in homogenous endometrium was done. After applying inclusion and exclusion criteria as the cases were evaluated with ultrasonography transvaginal scan (TVS). Histopathological correlation was done in all cases. The mean endometrial thickness in atrophic endometrium, hyperplasia, polyp and endometrial carcinoma were <4 mm, 15-18 mm, 15-18 mm, and >18 mm, respectively which was a significant difference between normal endometrium and carcinoma (P-value<0.05). Heterogenecity of endometrium was not diagnostic of endometrial cancer; however vessels in endometrial cancer were more prominent. TVS can be safely used as an imaging technique in the management of abnormal uterine bleeding. TVS has good accuracy and positive predictive value in diagnosis of endometrial cancer with endometrial thickness less than 4mm and good accuracy in diagnosis of atrophic endometrium.