title: [The value of three-dimensional multiplanar (MPV) and volume contrast imaging (VCI) in the ultrasound evaluation of endometrial pathology].
abstract: The aging of the women population as well as widespread use of the ultrasound leads to an increased detection of abnormal endometrial characteristics. The aim of this study was to assess the value of three-dimensional ultrasound viewing options: multi-planar view (MPV) and volume contrast imaging (VCI) in the endometrial evaluation. 147 women, referred for endometrial sampling, because of bleeding or an abnormal endometrial two-dimensional ultrasound image were enrolled in the study. Before dilation and curettage, all patients underwent three-dimension ultrasound scans for endometrial thickness measurements and endometrial-myometrial junction assessment. Ultrasound results and the presence of abnormal vaginal bleeding were compared with pathological diagnosis. Sensitivity, specificity, negative predictive value, and positive predictive value for abnormal vaginal bleeding, irregular endometrial-myometrial junction and endometrial thickness were established. Logistic regression model was used to assessed the relationship between the characteristics and the incidence of endometrial pathology. For each of the independent variables odds ratios were calculated. Sensitivity, specificity of the endometrial thickness cut-off 11 mm were 73.8%, 74.4%, for 10.5 mm 76.2%, 69.8% respectively. The irregular endometrial-myometrial junction reached 70.5% sensitivity and 93% specificity. Odds ratios for 10,5 mm cu-off value of the endometrial thickening and irregular E-M junction were calculated: 4.10 [95% CI: 1.14-14.74] and 36.07 [95% CI: 7.10-183.27]. The negative predictive value of any of these parameters did not exceed 70%. The combination of 3D ultrasound parameters and the occurrence of abnormal vaginal bleeding has reached only 53% sensitivity. In the case of connection of two of these three indices, increased sensitivity of 76.9% and specificity of 82.4%. In an unselected group of women in terms of menopausal status and symptoms endometrial thickness measured and the evaluation of endometrial-myometrial junction using 3D ultrasound is less value in predicting the occurrence of endometrial cancer than in 2D and the endometrial volume calculation.
authors.affiliation: Klinika Ginekologii i Onkologii, Collegium Medicum, Uniwersytetu Jagiellońskiego w Krakowie. a.nocun@gmail.com
authors.forename: Agnieszka
authors.initials: A
authors.lastname: Nocuń
authors.forename: Kazimierz
authors.initials: K
authors.lastname: Pityński
authors.forename: Marcin
authors.initials: M
authors.lastname: Wiecheć
authors.forename: Artur
authors.initials: A
authors.lastname: Ludwin
authors.forename: Robert
authors.initials: R
authors.lastname: Jach
authors.forename: Anna
authors.initials: A
authors.lastname: Knafel
authors.forename: Miłosz
authors.initials: M
authors.lastname: Pietrus
mesh_terms: D004714:Endometrial Hyperplasia / Q000000981:diagnostic imaging; D016889:Endometrial Neoplasms / Q000000981:diagnostic imaging*; D004717:Endometrium / Q000000981:diagnostic imaging*; D005260:Female; D006801:Humans; D021621:Imaging, Three-Dimensional / Q000379:methods*; D016015:Logistic Models; D008875:Middle Aged; D011237:Predictive Value of Tests; D012680:Sensitivity and Specificity; D014463:Ultrasonography; D014592:Uterine Hemorrhage / Q000000981:diagnostic imaging*