Three-dimensional 3D ultrasound combined with power Doppler for the differential diagnosis of endometrial lesions among infertile women

OBJECTIVE: To assess three-dimensional (3D) ultrasound combined with power Doppler (PD) for the differential diagnosis of endometrial lesions among infertile women. METHODS: A prospective study carried out at a reproductive medicine center in Luoyang, China, between January and December 2015. The inclusion criteria were asymptomatic infertility with normal endometrium or specific endometrial lesions. Participants were subdivided by whether they had normal endometrium (group 1, n=357), or endometrial lesions including polyps, hyperplasia, intrauterine adhesions, or endometritis (group 2, n=99). 3D PD and hysteroscopy were performed in the follicular phase. Endometrial thickness, volume, vascularization index (VI), flow index (FI), and vascularization flow index (VFI), and subendometrial VI, FI, and VFI were calculated. Endometrial lesions were confirmed by pathologic analysis. RESULTS: The overall prevalence of endometrial lesions was 99/456 (21.3%). Endometrial thickness and volume were significantly larger in group 2 than in group 1 (9.96 ± 3.24 vs 8.15 ± 2.50 mm and 3.70 ± 2.54 vs 2.42 ± 1.64 cm3 , respectively; both P<0.001). Endometrial thickness and volume were larger among women with endometrial polyps and hyperplasia; endometrial VI, FI, and VFI were lower among women with intrauterine adhesions. CONCLUSION: Three-dimensional PD has value for the differential diagnosis of endometrial lesions among infertile women. CLINICAL TRIAL REGISTRATION: The trial is registered in the Chinese Clinical Trial Registry as ChiCTR1800015799.