Three-dimensional Ultrasonography and Power Doppler for Discrimination Between Benign and Malignant Endometrium in Premenopausal Women With Abnormal Uterine Bleeding

Mohamed El-Sharkawy; Akmal El-Mazny; Wafaa Ramadan; Dina Hatem; Aly Abdel-Hafiz; Mohamed Hammam; Adel Nada

Disclosures

BMC Womens Health. 2016;16(18) 

In This Article

Results

Patients' characteristics and histopathological diagnosis are shown in Table 1. Of the 78 women included in the study, 68 (87 %) had benign endometrium and 10 (13 %) had malignant endometrium (atypical hyperplasia and carcinoma). Hysteroscopic and histopathologic findings were in agreement in almost all cases.

The age was significantly higher (P = 0.032) in patients with malignant endometrium; however, there were no significant differences in the parity (P = 0.954), weight (P = 0.952), height (P = 0.244), or body mass index (P = 0.248) between the two groups. The ET (P <0.001), EV (P <0.001), and endometrial VI (P <0.001) and VFI (P = 0.043) were significantly increased in patients with malignant endometrium; whereas, the uterine artery PI (P = 0.296) and RI (P = 0.922) and endometrial FI (P = 0.474) were not significantly different between the two groups (Table 2).

The diagnostic performance of the various ultrasound markers is shown in Table 3. The best marker for discrimination between benign and malignant endometrium was the VI with an AUC of 0.88 at a cutoff value of 0.81 %. The sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), likelihood ratio of a positive test (LR+), and likelihood ratio of a negative test (LR−) for endometrial VI at 0.81 % (90 %, 88 %, 53 %, 98 %, 7.50, and 0.11, respectively) were higher than those for ET at 19 mm (80 %, 72 %, 30 %, 96 %, 2.86, and 0.28, respectively), EV at 8 cm3 (90 %, 79 %, 39 %, 98 %, 4.29, and 0.13, respectively) and endometrial VFI at 0.22 (60 %, 68 %, 23 %, 92 %, 1.88, and 0.59, respectively).

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