Role of power doppler ultrasound in postmenopausal vaginal bleeding

الملخص EN

Aim of this study is to evaluate the changes occurring in the endometrium of postmenopausal patients with vaginal bleeding using gray-scale ultrasonography and the subendometrial power Doppler flow mapping and compare the result with histopathological examination of the performed endometrial curettage.

The study was then carried out including 50 patients suffering from postmenopausal bleeding.

Ultrasound and power Doppler mapping of the subendometrial blood vessels were done for each of the women included in the study.

The results were obtained, and comparison between various parameters was made.

Our results indicate that the use of these patterns as depicted by power Doppler is useful to discriminate endometrial carcinoma and endometrial polyps from other pathological processes but it is not useful to distinguish endometrial hyperplasia (sensitivity: 84.38 %).There were no false-positive cases for Pattern A, multiple vessel pattern, for that it could be considered as a diagnostic test for endometrial malignancy.

Pattern B, single vessel pattern, characteristic of polyps, was associated with 5 false-positive cases with endometrial hyperplasias.

Pattern C, scattered vessel pattern, characteristic of hyperplasia, had 2 false-positive cases with endometrial carcinomas.

Endometrial thickening is a non-specific finding that may be caused by several processes, such as cancer, polyps, and hyperplasia.

Conclusion: The use of power Doppler blood flow mapping as a secondary test in women not taking hormone replacement therapy or tamoxifen presenting with postmenopausal bleeding and a thickened endometrium at baseline sonography is useful to discriminate carcinoma and polyps from other pathological processes but it is not useful to distinguish endometrial hyperplasia (sensitivity: 84.38 %).

In addition, Endometrial thickening is a non-specific finding that may be caused by several processes, such as cancer, polyps, and hyperplasi.