Premium
Evaluation of color Doppler usefulness in diagnostics of pathological changes in endometrium supported by histological verification
Author(s) -
Stachowiak G.,
Jedrzejczyk S.,
Pertynski T.,
Polac I.,
Romanowicz H.
Publication year - 2001
Publication title -
ultrasound in obstetrics and gynecology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 3.202
H-Index - 141
eISSN - 1469-0705
pISSN - 0960-7692
DOI - 10.1046/j.1469-0705.2001.abs09-5.x
Subject(s) - medicine , pathological , endometrium , hyperplasia , endometrial cancer , endometrial hyperplasia , radiology , atypical hyperplasia , urology , pathology , gynecology , cancer
Purpose: To evaluate in Doppler examinations the frequency of vascularization and its character in individual types of pathological changes within endometrium in postmenopausal women without HRT on the basis of histological verification. Methods: A total of 327 postmenopausal women were under initial uniform diagnostic algorithm ended in dilatation and curretage or hysteroscopy with uterine sampling for histopathological examination. In all the patients, vaginal sonography, and then color Doppler study was performed. The frequency of vascularization, its character and distribution, resistance and pulsatility indices in uterine arteries and in detected vessels inside pathological changes were estimated. Results: In all cases, in which in histological results did not show any pathological changes, no intraendometrial flows were detected in Doppler examination. Internal vascularization was found in 69% of patients with submucosal fibroids, in 66% of patients with endometrial polyps, in 37% of patients with endometrial hyperplasia, whereas in 78% of patients with endometrial cancers. In 50% of patients with endometrial hyperplasia regular distributed internal vascularization was found, however, in 66.7% of patients with endometrial cancer ample irregular distribution of vascularization was detected. Doppler flows in arteries detected in pathological changes showed mean lowered PI and RI only in the group with endometrial hyperplasia and no statistically significant changes in the above indices in the groups with other pathological changes. In uterine arteries, statistically significant lowering of both RI and PI in the group with hyperplasia was found as well as in the group with endometrial cancers, whereas statistically significant increased PI were measured in the group with endometrial polyps. Conclusions: (1) Detection of endometrial flows during color Doppler examination in postmenopausal women without HRT may be a substantial sign of pathology requiring histological verification. (2) Lowering of RI and PI in uterine arteries together with irregular distribution of vascularization inside endometrial echo may be auxiliary elements in sonographic differentiation of endometrial cancers from other pathological changes. (3) Lowered RI and PI both in uterine arteries and arteries inside endometrial echo seem to be characteristic features of endometrial hyperplasia.