Combination of B-Mode Ultrasound and Doppler Ultrasound in Approaching to Uterine Intracavitary Pathologies Among Women Above 40 Years with Abnormal Uterine Bleeding: A Multicenter-Based Study from Vietnam

Phúc Nhơn Nguyễn, Van Tuan Nguyen
In: Journal of Mid-life Health · 2022 · vol. 13(2) , pp. 145–151 · doi:10.4103/jmh.jmh_93_22 · PMID:36276626 · W4307234887
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This multicenter study in Vietnamese women over 40 with abnormal uterine bleeding found that combining B-mode and Doppler ultrasound effectively differentiates benign from malignant intracavitary pathologies, though it does not specifically address endometriosis or adenomyosis.

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This prospective observational study evaluated the diagnostic utility of combining B-mode and Doppler transvaginal ultrasound for identifying uterine intracavitary pathologies in 150 women over age 40 presenting with abnormal uterine bleeding. Researchers compared sonographic findings against histopathological results, determining that morphological features, lesion borders, and specific Doppler vascular patterns significantly distinguished between benign conditions like polyps and fibroids and malignant entities such as endometrial cancer. While echogenicity proved limited, the pedicle sign and circular pattern demonstrated high specificity for polyps and fibroids respectively, whereas multiple vessel patterns aided in detecting malignancy. The paper does not explicitly discuss endometriosis or adenomyosis; it was included in the corpus via a keyword match in the upstream search index.

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Abstract

Objectives: To determine the role of B-mode ultrasonography combined with Doppler ultrasonography in diagnosing uterine intracavitary pathology in perimenopausal and postmenopausal women with abnormal uterine bleeding (AUB). Patients and Methods: This prospective observational study included 150 women aged >40 years with AUB hospitalized at Hue University Hospital and Hue Central Hospital between 6/2016 and 6/2019. All participants were investigated by B-mode transvaginal ultrasound and Doppler transvaginal ultrasound, and the result of sonography was compared to the histopathological endpoint. Results: The morphological features, structure, margin, border line of the endometrial-mass lesion, intracavitary uterine fluid, and Doppler signal clearly differed between benign and malignant intracavitary pathologies ( P < 0.0001). However, echogenicity had a limited value in distinguishing between uterine intracavitary pathologies ( P = 0.1). The sensitivity and specificity of the pedicle sign in diagnosing endometrial polyps were 50.0% and 97.6%, respectively; for the circular pattern in subendometrial fibroids were 46.2% and 100.0%, respectively; for the multiple vessel pattern in endometrial cancer were 64.0% and 96.0%, respectively, and for the scattered-vessel pattern in endometrial hyperplasia were 43.96% and 56.43%, respectively. Conclusions: Ultrasound B-mode combined with Doppler as a noninvasive tool was significantly valuable in the diagnostic procedures for uterine intracavitary pathology in perimenopausal and postmenopausal women with AUB. It could also help differentiate malignant diseases from benign endometrial changes.
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Objectives

To determine the role of B-mode ultrasonography combined with Doppler ultrasonography in diagnosing uterine intracavitary pathology in perimenopausal and postmenopausal women with abnormal uterine bleeding (AUB). Patients and Methods: This prospective observational study included 150 women aged >40 years with AUB hospitalized at Hue University Hospital and Hue Central Hospital between 6/2016 and 6/2019. All participants were investigated by B-mode transvaginal ultrasound and Doppler transvaginal ultrasound, and the result of sonography was compared to the histopathological endpoint.

Results

The morphological features, structure, margin, border line of the endometrial-mass lesion, intracavitary uterine fluid, and Doppler signal clearly differed between benign and malignant intracavitary pathologies (P < 0.0001). However, echogenicity had a limited value in distinguishing between uterine intracavitary pathologies (P = 0.1). The sensitivity and specificity of the pedicle sign in diagnosing endometrial polyps were 50.0% and 97.6%, respectively; for the circular pattern in subendometrial fibroids were 46.2% and 100.0%, respectively; for the multiple vessel pattern in endometrial cancer were 64.0% and 96.0%, respectively, and for the scattered-vessel pattern in endometrial hyperplasia were 43.96% and 56.43%, respectively.

Conclusions

Ultrasound B-mode combined with Doppler as a noninvasive tool was significantly valuable in the diagnostic procedures for uterine intracavitary pathology in perimenopausal and postmenopausal women with AUB. It could also help differentiate malignant diseases from benign endometrial changes. Copyright © 2022 Copyright: © 2022 Journal of Mid-life Health

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