TVUS coated with power Doppler in endometrial hyperplasia in pre and postmenopausal women presenting with an abnormal uterine bleeding (A Cohort Study)

PURPOSE: The purpose of this study was to determine if power Doppler added to grey scale TVS can replace invasive methods for predicting endometrial pathology in pre- and postmenopausal women with abnormal uterine bleeding (AUB).

MATERIALS AND METHODS: Following a thorough history and physical examination, 200 women (>45 year old) with pre- or postmeno-pausal AUB underwent evaluation with TVS, power Doppler, and hysteroscopic endometrial biopsy in this cohort study. Histopathology was regarded as the gold standard, and it was contrasted with other instruments such power Doppler greyscale TVS. Furthermore it was computed the positive and negative predictive values (NPV and PPV), specificity, sensitivity, and specificity.

RESULTS: TVPDUS diagnosed endometrial hyperplasia in 145 cases (72.5%). Endometrial hyperplasia was diagnosed in 158 (79%) cases by histopathological results including either simple cystic hyperplasia in 145 cases, simple atypical hyperplasia in 10 cases and 3 cases were complex hyperplasia. The accuracy, sensitivity, specificity, PPV, and NPV were 88.25%, 90.7%, 84%, 97.7%, and 84 % in premenopause while was 100 % in postmenopausal women in all reported results. hyperplasia. The accuracy, sensitivity, specificity, PPV, and NPV were 88.25%, 90.7%, 84%, 97.7%, and 84 % in premenopause.

CONCLUSION: High resolution TVS with PD is an appropriate diagnostic tool in both pre and post menopausal females presenting with an abnormal uterine bleeding, and assessing endometrial hyperplasia. However, further studies by histopathological examinations are needed for demonstrating its accuracy in diagnosing EH.