Accuracy of power Doppler ultrasonography for detecting intrauterine focal lesions: a correlation with doppler ultrasound and hysteroscopic hystopathology

Objective

To compare power Doppler flow mapping characteristics of endometrial polyps and submucosal fibroids and analyze whether different power Doppler characteristics can help to differentiate these focal endometrial lesions.

Methods

Fifty-eight women (median age, 37 years; range, 25–51 years) presenting with abnormal uterine bleeding and infertility on transvaginal ultrasund suggested focal endometrial lesions underwent sonohysterography were included in this prospective study. Three different vascular patterns were defined: Pattern A: single-vessel pattern, Pattern B: rim-like vessel pattern C: multiple vessel pattern. These were compared with the final histopathological diagnosis.

Results

Histological diagnoses were as follows: Endometrial polyp 40 (69%), submucousal myoma 18 (31%). Power Doppler signals were observed in 53 of these; they were not observed in five patients with endometrial polyps. We find out 75% pattern A, 2.5% pattern B and 7.5% pattern C in vascularized polyps, and also submucous myomas we find out 5.6% pattern A, 66.7% pattern B and 27.8% pattern C. The sensitivity, specificity and positive and negative predictive values for single vessel pattern in diagnosing endometrial polyps were 80, 100, 100, and 69.23%; for multiple vessels pattern in diagnosing submucousal myomas were 27.78, 92.5, 62.5 and 74%; for rim-like vessel pattern in diagnosing submucosal fibroids, they were 72.22, 100, 100 and 88.9%, respectively.

Conclusion

Power Doppler blood flow mapping is reasonable in the diagnosis of intrauterine focal lesions and is practical in distinguishing endometrial polyps and submucosal fibroids.

Keywords

Power Doppler, hysteroscopy, focal intrauterine lesions.