title: Three-dimensional ultrasonography and power Doppler for discrimination between benign and malignant endometrium in premenopausal women with abnormal uterine bleeding.
abstract: BACKGROUND
  Ultrasonography has been extensively used in women suspected of having a gynecological malignancy. The aim of this study is to evaluate the efficacy of 3D ultrasonography and power Doppler for discrimination between benign and malignant endometrium in premenopausal women with abnormal uterine bleeding.
  
  
  METHODS
  This cross-sectional study included 78 premenopausal women with abnormal uterine bleeding scheduled for hysteroscopy and endometrial curettage. The endometrial thickness (ET), uterine artery pulsatility index (PI) and resistance index (RI), and endometrial volume (EV) and 3D power Doppler vascularization index (VI), flow index (FI), and vascularization flow index (VFI) were measured and compared with hysteroscopic and histopathologic findings.
  
  
  RESULTS
  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 atypical endometrial hyperplasia and endometrial carcinoma (n = 10) than those with benign endometrium (n = 68); whereas, the uterine artery PI and RI and endometrial FI were not significantly different between the two groups. The best marker for discrimination between benign and malignant endometrium was the VI with an area under the ROC curve of 0.88 at a cutoff value of 0.81%.
  
  
  CONCLUSIONS
  3D ultrasonography and power Doppler, especially endometrial VI, may be useful for discrimination between benign and malignant endometrium in premenopausal women with abnormal uterine bleeding.
authors.affiliation: Department of Obstetrics and Gynecology, Faculty of Medicine, Cairo University, Cairo, Egypt. kingdoc82@outlook.com.
authors.forename: Mohamed
authors.initials: M
authors.lastname: El-Sharkawy
authors.affiliation: Department of Obstetrics and Gynecology, Faculty of Medicine, Cairo University, Cairo, Egypt.
authors.forename: Akmal
authors.initials: A
authors.lastname: El-Mazny
authors.affiliation: Department of Obstetrics and Gynecology, Faculty of Medicine, Cairo University, Cairo, Egypt.
authors.forename: Wafaa
authors.initials: W
authors.lastname: Ramadan
authors.affiliation: Department of Obstetrics and Gynecology, Faculty of Medicine, Cairo University, Cairo, Egypt.
authors.forename: Dina
authors.initials: D
authors.lastname: Hatem
authors.affiliation: Department of Obstetrics and Gynecology, Faculty of Medicine, Cairo University, Cairo, Egypt.
authors.forename: Aly
authors.initials: A
authors.lastname: Abdel-Hafiz
authors.affiliation: Department of Obstetrics and Gynecology, Faculty of Medicine, Cairo University, Cairo, Egypt.
authors.forename: Mohamed
authors.initials: M
authors.lastname: Hammam
authors.affiliation: Department of Obstetrics and Gynecology, Faculty of Medicine, Cairo University, Cairo, Egypt.
authors.forename: Adel
authors.initials: A
authors.lastname: Nada
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003430:Cross-Sectional Studies; D016889:Endometrial Neoplasms / Q000150:complications* / Q000175:diagnosis*; D004717:Endometrium / Q000000981:diagnostic imaging* / Q000473:pathology; D005260:Female; D006801:Humans; D021621:Imaging, Three-Dimensional; D008875:Middle Aged; D018608:Ultrasonography, Doppler / Q000295:instrumentation* / Q000379:methods / Q000706:statistics & numerical data*; D014592:Uterine Hemorrhage / Q000175:diagnosis*
keywords: 3D ultrasonography; Doppler; Endometrial carcinoma; Hysteroscopy; Premenopausal bleeding