Evaluation of endometrial polyps.
OBJECTIVE
Endometrial polyps are relatively common in all groups of women. More polyps are being diagnosed with the widespread use of transvaginal ultrasound scanning and sonohysterography. The reported incidence of malignancy is low. The potential benefit of a noninvasive technique to distinguish benign from malignant polyps is obvious. This study was undertaken to evaluate endometrial polyps by color flow Doppler ultrasound scanning and histopathologic examination.


METHODS
This was an observational study of patients with an endometrial polyp on sonohysterography who underwent interrogation of their polyp with color Doppler ultrasound scanning and subsequently polypectomy. Polyp volume, resistive index, pulsatility index, indication for scan (bleeding vs incidental), and patient age were correlated with histopathologic type of the polyp (nonfunctional, proliferative, secretory, hyperplastic, or malignant).


RESULTS
Of 61 patients studied, 42 patients (68.9%) were scanned for abnormal bleeding, and 19 patients (31.1%) had their polyps discovered incidentally. There were no statistically significant differences between histologic categories and the resistive index, pulsatility index, or size of the polyp. The age of patients with nonfunctional polyps was significantly greater than any other group (P <.001). Ninety-four percent of the functional polyps were discovered because of abnormal bleeding; 38% of the nonfunctional polyps were discovered incidentally (P <.001).


CONCLUSIONS
The data suggest that the objective assessment of blood flow impedance (resistive index, pulsatility index) in endometrial polyps and the size of these polyps cannot replace surgical removal and pathologic evaluation to predict histologic type. Patients with nonfunctional polyps were older and less likely to have vaginal bleeding.
Goldstein
Steven R
SR
Department of Obstetrics & Gynecology, Division of Obstetrics and Gynecology Pathology, New York University School of Medicine, New York, NY, USA. steven.goldstein@med.nyu.edu
Monteagudo
Ana
A
Popiolek
Dorota
D
Mayberry
Pat
P
Timor-Tritsch
Ilan
I
D000328:Adult; D016889:Endometrial Neoplasms / Q000098:blood supply / Q000000981:diagnostic imaging* / Q000473:pathology*; D005260:Female; D006801:Humans; D011127:Polyps / Q000098:blood supply / Q000000981:diagnostic imaging* / Q000473:pathology*; D011673:Pulsatile Flow; D018615:Ultrasonography, Doppler, Color; D014592:Uterine Hemorrhage; D014655:Vascular Resistance