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Additional value of Doppler ultrasound to B-mode ultrasound in assessing for uterine intracavitary pathologies among perimenopausal and postmenopausal bleeding women: a multicentre prospective observational study in Vietnam

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Abstract

Purpose

To determine the role of Doppler ultrasonography when combined with B-mode ultrasonography in diagnosing uterine intracavitary pathologies (UIPs) in perimenopausal and postmenopausal bleeding women.

Methods

This multicentre prospective observational study included 150 women aged > 40 years with abnormal uterine bleeding (AUB), who were hospitalised at Hospital X and Hospital Y between June 2016 and June 2019. All participants underwent transvaginal B-mode ultrasound and transvaginal Doppler ultrasound, and the results of sonography were compared to histopathological endpoint.

Results

The morphological features, structure, margin, border line of the endometrial-mass lesion, intracavitary uterine fluid, and Doppler signal clearly differed between benign and malignant intracavitary pathologies (p < 0.0001). However, echogenicity had a limited value in differentiating among UIPs (p = 0.1). The sensitivity and specificity of the pedicle sign in diagnosing endometrial polyps were 50.0% and 97.6%; for the circular pattern in endometrial fibroids were 46.2% and 100.0%; for the multiple vessel pattern in endometrial cancer were 64.0% and 96.0%; and for the scattered vessel pattern in endometrial hyperplasia were 43.96% and 56.43%, respectively. The additional value of Doppler ultrasound was greater than that of separate B-mode ultrasound in assessing UIPs in our study.

Conclusions

B-mode ultrasound used in combination with Doppler as a noninvasive tool was significantly valuable in the diagnostic procedures for UIPs in perimenopausal and postmenopausal bleeding women. Doppler ultrasound and B-mode transvaginal ultrasound should be used together routinely for discrimination between malignant diseases and benign endometrial changes. Further studies are needed to better understand the benefits of combining Doppler ultrasound and B-mode ultrasound in routine sonographic practice.

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Data availability

The datasets used and/or analyzed during the current study are available from the corresponding author on reasonable request.

Abbreviations

AUB:

Abnormal uterine bleeding

EC:

Endometrial cancer

EH:

Endometrial hyperplasia

EP:

Endometrial polyps

EF:

Endometrial fibroid

TV-CDU:

Transvaginal color Doppler ultrasound

UIPs:

Uterine intracavitary pathologies

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Acknowledgments

We thank the patients, who agreed to allow us to participate in our research and to publish their clinical data. The authors are also grateful to all teachers and colleagues working at the Department of Gynecology, the Department of Image Diagnostic, and the Department of Histopathology at Hue Central Hospital and at Hue University Hospital. We are thankful directly to PhD. M.D Van Duc Vo, Ph.D. M.D Thao Nguyen Nguyen Tran, M.D. Ngoc Ty Nguyen Thi., M.D. Diem Thu Nguyen Thi, M.D. Phuong Minh Nguyen Thi, M.D. Thanh Thuy Tran Thi. All of them attributed to provide us the pictures, take care for patient and shared their precious experiences related to manage this clinical course with us.

Funding

The authors received no financial support for the research, authorship, and/or publication of this article.

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Authors and Affiliations

  1. Department of High-Risk Pregnancy, Tu Du Hospital, 284 Cong Quynh, Pham Ngu Lao ward, District 1, Ho Chi Minh City, 730000, Vietnam

    Phuc Nhon Nguyen

  2. Clinical Research Unit, Tu Du Hospital, Ho Chi Minh City, Vietnam

    Phuc Nhon Nguyen

  3. Hue Medical College, Hue University, Thua Thien Hue, Vietnam

    Van Tuan Nguyen

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  1. Phuc Nhon Nguyen
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Correspondence to Phuc Nhon Nguyen.

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Conflict of interest

The authors declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Ethical approval

This study was approved by Ethical Committee of the Hue University of Medicine and Pharmacy with IRB approval number 1435/QD-DHYD.

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Written informed consent was obtained from the patients for recruitment in study.

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Nguyen, P.N., Nguyen, V.T. Additional value of Doppler ultrasound to B-mode ultrasound in assessing for uterine intracavitary pathologies among perimenopausal and postmenopausal bleeding women: a multicentre prospective observational study in Vietnam. J Ultrasound 26, 459–469 (2023). https://doi.org/10.1007/s40477-022-00732-w

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