DIAGNOSIS OF ENDOMETRIAL CARCINOMA - PREDICTIVE VALUE OF TRANSVAGINALCOLOR DOPPLER

The objective of this study was to determine whether transvaginal ultr asound plus color Doppler flow improve the ability to diagnose endomet rial carcinoma and allow better discrimination between benign and mali gnant endometrial lesions. One hundred thirty women with abnormal uter ine bleeding were evaluated with transvaginal color Doppler before fra ctional dilatation and curettage (D&C). The endometrial line thickness and endometrical characteristics were evaluated by endosonography. Th e resistive and pulsatile indices of the uterine arteries and of the e ndometrium were evaluated with transvaginal color Doppler. Following D &C and tissue diagnosis, women were divided into two groups, 62 with a histologic diagnosis of endometrial adenocarcinoma and 68 with benign endometrial tissue. All women with endometrial carcinoma underwent TA H and BSO. A complete histopathologic study was done an all surgical s pecimens. The International Federation of Gynecology and Obstetrics (F IGO) stage and tissue grading were determined in all cases. The histop athologic findings were correlated with ultrasound and transvaginal co lor Doppler results. Patients with adenocarcinoma had an average endom etrial thickness of 26.13 mm (range 8-87 mm). The average thickness fo r functional endometrium (proliferative) was 10.5 mm (range 6-23 mm). The was no case of carcinoma where the endometrial thickness was less than 8 mm. Intraendometrial neovascularization was not observed in any case with functional or atrophic endometrium. The flow indices in pat ients with endometrial adenocarcinoma are significantly different from the flow indices of patients with benign endometrial tissue. Transvag inal color Doppler increases the sensitivity of endometrial malignancy diagnosis. The method is capable of detecting important differences i n flow indices and endometrial line characteristics between benign and malignant endometrial tissue.