Combined transvaginal ultrasonography and uterine artery color doppler in prediction of endometrial pathology in cases of postmenopausal bleeding / Ebtsam Mohammed Nagil Mohammed ; Supervised Ahmed Abdelmguid Attia , Ahmed Mohammed Mostafa Elhalwagi , Ahmed Samir Rashwan

Thesis (M.Sc.) - Cairo University - Faculty of Medicine - Department of Gynecology and Obstetrics

Objective:The objective of this study was to evaluate the ability of transvaginal ultrasonographyandcolorDoppler examination in discrimination between benign and malignant and between normal and pathologic endometrium in women with postmenopausal bleeding. Study design:One hundred consecutive women of postmenopausal bleeding underwent transvaginal ultrasonography, including color and spectral Doppler technique.The thickness of the endometrium was measured. Doppler signals of the maximum blood flow velocity obtained from the two main uterine arteries were evaluated for pulsatility index and resistance index. Those patients went for fractional curettage later on and the results of the examinations were compared with the histologic diagnosis of the curettage specimen. Results:Comparisons between quantitative variables were done using the non-parametric Mann-Whitney test. ROC curve was constructed with area under curve analysis performed to detect best cutoff value of endometrial thickness{u2264} 6.5, RI{u2264} 0.71and PI{u2264}1.2 for detection of uterine carcinoma. P-values less than 0.05 were considered as statistically significant. Conclusion:Measurement of endometrial thickness with transvaginalultrasonography and Doppler velocimetry of the uterine arteries are better method for discriminating between benign and malignant or normal and pathologic endometrium

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