title: Reproducibility of endometrial vascular patterns in endometrial disease as assessed by transvaginal power Doppler sonography in women with postmenopausal bleeding.
abstract: OBJECTIVE
  The purpose of this study was to assess the intraobserver and interobserver agreement for identifying different endometrial vascular patterns using power Doppler sonography in women with postmenopausal bleeding and a thickened endometrium.
  
  
  METHODS
  Digitally stored sonographic images from a random sample of 65 patients with postmenopausal bleeding and a thick endometrium (>5 mm) on B-mode sonography and evaluated by transvaginal power Doppler sonography for assessment of endometrial blood flow mapping were evaluated by 5 different examiners with different levels of expertise in Doppler sonography. Intraobserver and interobserver agreement according to the level of experience were assessed by calculating the kappa index.
  
  
  RESULTS
  Intraobserver agreement was good or very good for all experienced examiners (kappa = 0.78-0.96) and moderate (kappa = 0.52) for the inexperienced examiner. Interobserver agreement was moderate among all experienced examiners (kappa = 0.45-0.80). The inexperienced examiner showed fair or moderate interobserver agreement (kappa = 0.32-0.45).
  
  
  CONCLUSIONS
  Our results indicate that endometrial blood flow mapping using transvaginal power Doppler sonography is acceptably reproducible. More experience was associated with better intraobserver and interobserver agreement.
authors.affiliation: Department of Obstetrics and Gynaecology, Clínica Univeristaria de Navarra, Pamplona, Spain. jlalcazar@unav.es
authors.forename: Juan Luis
authors.initials: JL
authors.lastname: Alcázar
authors.forename: Silvia
authors.initials: S
authors.lastname: Ajossa
authors.forename: Stefano
authors.initials: S
authors.lastname: Floris
authors.forename: Roberta
authors.initials: R
authors.lastname: Bargellini
authors.forename: Marta
authors.initials: M
authors.lastname: Gerada
authors.forename: Stefano
authors.initials: S
authors.lastname: Guerriero
mesh_terms: D002983:Clinical Competence; D004717:Endometrium / Q000098:blood supply* / Q000473:pathology; D005260:Female; D006801:Humans; D008875:Middle Aged; D017698:Postmenopause; D015203:Reproducibility of Results; D018608:Ultrasonography, Doppler; D014592:Uterine Hemorrhage / Q000000981:diagnostic imaging*