title: Three-dimensional power Doppler and endometrial volume as predictors of malignancy in patients with postmenopausal bleeding.
abstract: OBJECTIVE
  The aim of this study was to evaluate the efficacy of 3D power Doppler angiography (3D-PDA) for distinguishing between benign endometrial lesions and endometrial carcinoma in patients with postmenopausal bleeding (PMB).
  
  
  METHODS
  One-hundred and fifty women with PMB and an endometrial thickness (ET) of ≥4 mm on 2D sonography were assessed by 3D-PDA before endometrial sampling to obtain definitive histological diagnosis of endometrial pathology. Endometrial volume (EV), vascularity index (VI), flow index (FI) and vascularity-flow index (VFI) were calculated by computer-aided analysis.
  
  
  RESULTS
  Of the 150 women, 114 (76%) had benign endometrial lesions and 36 (24%) had endometrial carcinoma. Patients with endometrial carcinoma had significantly thicker endometrium (15.8 ± 7.7 vs 9.9 ± 5.9 mm; P < 0.001), larger EV (9.1 ± 4.7 vs 2.6 ± 3.5 mL, P < 0.001) and higher 3D-PDA indices (P < 0.001) than patients with benign endometrial lesions. The best variable for distinguishing between benign and malignant endometrium was VI, with an area under the receiver operating characteristic curve (AUC) of 0.86. In contrast, the ET had an AUC of only 0.62. The best-fit logistic regression model for the diagnosis malignancy contained only VI as an independent factor (P = 0.002).
  
  
  CONCLUSIONS
  3D-PDA measurements may be useful for distinguishing between benign endometrial lesions and endometrial carcinoma in patients with postmenopausal bleeding.
authors: Department of Obstetrics and Gynecology, Faculty of Medicine, Ain Shams University Maternity Hospital, Cairo, Egypt.
authors: Ahmed K
authors: AK
authors: Makled
authors: Sherif F
authors: SF
authors: Elmekkawi
authors: Tamer A
authors: TA
authors: El-Refaie
authors: Mohammed A
authors: MA
authors: El-Sherbiny
mesh_terms: D000368:Aged; D002277:Carcinoma / Q000000981:diagnostic imaging* / Q000503:physiopathology; D016889:Endometrial Neoplasms / Q000000981:diagnostic imaging* / Q000503:physiopathology; D004717:Endometrium / Q000000981:diagnostic imaging* / Q000503:physiopathology; D005260:Female; D006801:Humans; D021621:Imaging, Three-Dimensional; D008875:Middle Aged; D017698:Postmenopause; D012680:Sensitivity and Specificity; D018608:Ultrasonography, Doppler; D014591:Uterine Diseases / Q000000981:diagnostic imaging / Q000503:physiopathology; D014592:Uterine Hemorrhage / Q000209:etiology*