EP26.16: B‐mode ultrasound combined with Doppler ultrasound in approaching to uterine intracavitary pathologies in peri‐ and postmenopausal bleeding women

Abnormal uterine bleeding is common complaint in perimenopausal and postmenopausal women. Existing etiologies leading to this symptom included benign and malignant disease. Assessment of structural intrauterine abnormality is often difficult in condition of low-resource settings as Vietnam. Through this study, we aimed 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) in Vietnam. This observational study included 150 women aged >40 years with abnormal uterine bleeding hospitalised at Hue University Hospital and Hue Central Hospital between 6/2016-6/2019. All participants were investigated by B-mode transvaginal ultrasound and Doppler transvaginal ultrasound, and the result of sonography were compared to the histopathological endpoint. 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, 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%, 96.0%, respectively and for the scattered-vessel pattern in endometrial hyperplasia were 43.96% and 56.43%, respectively. B-mode ultrasound combined with Doppler ultrasound as a non-invasive tool was significantly valuable in the diagnostic procedures for uterine intracavitary pathology in perimenopausal and postmenopausal bleeding women. It could also help differentiate malignant diseases from benign endometrial changes in low-resource settings as Vietnam.