Relevance of the Doppler flowmetry in the diagnosis of pathological alterations in the post-menopausal endometrium

The sonopathomorphology of the menopausal endometrium was investigated by m easuring the endometrium thickness using the Doppler flowmetry technique. T he endometrium thickness extending five millimeters has been considered cri tical, indicating possible neoplastic disorders. Such clinical status has b een discovered in 21 out of 58 post-menopausal patients inspected (36.2%). Furthermore, the Doppler blood-flow analysis, based on the evaluation of th e resistance indices (RI) in the ascendent branches of uterine arteries bil aterally, and - in case of the vascularization analysis - in the edometrial and perimetrial regions, has been performed. These investigations brought evidence indicating full capacity of the method in detecting blood flow thr ough the uterine arteries, while significant differences in the endometrial flow-through parameters were detected only in 14 (66.7%) patients. In all 21 patients with endometrium thickness extending 5 millimeters, bioptic exa mination followed by histology confirmed endometrial cancer in 9 patients, epidermoid cancer in 3 patients, and cystic hyperplasia in 3 patients, resp ectively. The remaining 6 patients showed either secretory or quiet endomet rium (5 cases), or necrotic endometrial regions (1 case). In all 12 cases o f malignant endometrial cancer and in 2 out of 3 cases of histologically ve rified benign hyperplasia, intra- and periendometrial vascularization has b een confirmed. It is to note that the mean RI values measured in the intra- and periendometrial vessels in case of endometrial cancer were significant ly lower than in patients with benign cystic hyperplasia of the endometrium . Our results brought evidence indicating that the estimation of difference s in the RI values in patients with detectable intra- and periendometrial v ascularization has a significant relevance in the distinction of endometria l cancer from nonmalignant endometrial lesions, predominantly the benign at ypical hyperplasia. The reliability of the test was 100%, however - in case of malignant disorders - a significant decrease in the RI values has been seen in the intratumoral vs. peritumoral vascularization.