Objective: to compare the accuracy of transvaginal ultrasonography colour flow mapping and measurementof Doppler indices of the uterine artery (P.I., R.I. and S/D ratio)in the diagnosis of different types of abnormal uterine bleeding thought to be of endometrial origin.
Study design and setting:This is a prospective case control study including 53 women attending the gynecology department of Sohag University Hospital ith different types of abnormal uterine bleeding thought at clinical assessment and ultrasonography to be of endometrial origin compared to 36 controls (20 during child bearing age and 16 postmenopausal).
Intervention: Both patients and controls underwent thorough clinical and ultrasonographic examination then colour flow mapping of the lesions in the patients . Doppler indices of the uterine arteries were determined for the two groups and the final diagnosis was then dtermined by histopathology using a D&C operation for the patients.
Outcome measures: The endometrial thickness at TVS, the ultrasonographic evidence of myometrial invasion, P.I., R.I.,and S/D ratio for both groups.
Results: The control group included 20 child bearing and 16 postmenopausal women the mean age, parity and endometrial thickness for the two groups were 27.6 +4.5, 2.6++1.8, 5.6+1.2 versus 55.6+7.8, 5.5+2.2, 3.26+0.51 respectively.They were sinificantly different in all these variables, p< 0.001. for the P.I., R.I and S/D ratio they were practically indifferent (2.2+0.35, 0.85+0.03 and 6.89+1.39 versus 2.33+0.57, 0.86+0.04 and 7.84+1.96, p>0.05), histopathology divided the patients into four groups; 24 with hyperplasia,7 with atypia and 7 with carcinoma. The mean age and parity four these groups were 36.4+8.01, 39.0+9.9, 41.0+4.7 and 56.8+6.71 for age and 4.3+2.4, 3.4+2.5, 2.8+3.2 and 0.88+1.7 for the parity respectively. Endometrial thickness was 7.83+1.9, 15.9+3.9,19.5+6.2 and 24.4+0.8 for the four groups respectively. doppler flow indices of the uterine arteries were as follow: the mean PI was 2.45+0.56, 1.83+0.45, 1.31+0.1 and 0.91+0.93, the mean R.I. WAS 0.84+0.059, 0.79+0.05, 0.71+0.05 and 0.58+0.02 and the mean S/D ratio was8.29+3.69, 5.29+1.56, 3.4+0.68 and 2.4+0.01 for the four pathological varieties respectively. PI less than 1 and R.I. less than 0.66 has a 100% sensitivity, specificity, positive and negative predective values for the diagnosis of endometrial malignancy.