Effectiveness of Three-dimensional Power Doppler Imaging in Discrimination between Benign and Malignant Endometria in Women with Postmenopausal Bleeding
XI Mei1, QIAN Min2,LIU Wei-xing1, SUN Kun1, BI Ying-ying1, GUO Hui-yue1
1. Department of Ultrasound, General Hospital of Armed Police Forces, Beijing 100039, China; 2. Department of Ultrasound, Fuxing Hospital, Capital Medical University, Beijing 100038, China
Abstract：Objective To evaluate the value of blood flow parameters measured through the three-dimensional power Doppler angiography (3D- PDA) in discrimination between benign and malignant endometria in women with postmenopausal bleeding. Methods With examination of 79 women suffering from postmenopausal bleeding with 3D- PDA, blood flow parameters involving volume (V), vascularization index (VI), flow index (FI) and vascularization flow index (VFI) could be measured. On the basis of pathological results, all the patients were divided into two groups: the Benign Group (25 cases with endometrial polyps and 34 cases with endometrial hyperplasia) and the Malignant Group (20 cases with endometrial carcinoma). The receiver operating characteristic (ROC) curve was applied to evaluate the blood flow parameters in discrimination of benign and malignant endometria. Results The endometrial volume was 7.02±3.02 ml and 8.61±2.43 ml in the Benign Group and Malignant Group respectively, which showed significant difference between two groups (P<0.05). When pulse repetition frequency (PRF) was set at 0.9 MHz, the VI, FI and VFI in the Benign Group were 1.67±1.11 %, 25.07±2.67 and 0.43±0.29 respectively; while the VI, FI and VFI in the Malignant Group were 6.00±5.58 %, 31.56±4.54 and 2.05±1.72 respectively, which were of statistical significance between two groups (P<0.05). When different PRF were set at 0.9 MHz/0.6 MHz, the parameters of VI and VFI were considered statistically significant (P<0.05) while the parameter of FI had no significant differences (P>0.05) in the Benign Group and Malignant Group. The area under curve (AUC) of the VI, FI and VFI in ROC were 0.966, 0.913 and 0.973 respectively, which accurately predicted malignant lesions of endometria. Among these parameters, VFI had the highest diagnostic value for differentiation between benign and malignant endometria. The sensitivity and specificity were 95% and 91.5% respectively when the cut-off value of VFI was 0.814. Conclusion 3D-PDA could quantify the vascular distribution and density of lesioned endometria and was a good diagnostic tool in differentiation between benign and malignant endometria in women with postmenopausal bleeding.
席梅，钱敏，刘卫星，孙鲲，毕营营，郭慧越. 三维能量多普勒对绝经期子宫内膜良恶性病变的鉴别价值[J]. 中国医疗设备, 2013, 28(7): 151-154.
XI Mei, QIAN Min,LIU Wei-xing, SUN Kun, BI Ying-ying, GUO Hui-yue. Effectiveness of Three-dimensional Power Doppler Imaging in Discrimination between Benign and Malignant Endometria in Women with Postmenopausal Bleeding. China Medical Devices, 2013, 28(7): 151-154.
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Mansour GM,El-Laraie[K,E]l-Kady MA,el a1.Endometfial volume as predictor of malignancy in women with postmenopausal bleeding[J].Int J Gynaeeol Obstet.2007,99(3):206-210.
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Odeh M,Vainerovsky I,Grinin V,et a1.Three-dimensional endometrial volume and 3-dimensional power Doppler analysis in predicting endometrial carcinoma and hyperplasia[J].Gynecol Oncol,2007,106(2):348-353.
