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Contribution of spiral artery blood flow changes assessed by transvaginal color Doppler sonography for predicting endometrial pathologies

Year 2013, Volume: 40 Issue: 3, 345 - 349, 01.09.2013
https://doi.org/10.5798/diclemedj.0921.2013.03.0287

Abstract

Objective: To investigate the diagnostic value of blood flow measurements in spiral artery by transvaginal color Doppler sonography (CDS) in predicting endometrial pathologies. Methods: Ninety-seven patients presenting with abnormal uterine bleeding and requiring endometrial assessment were included in this prospective observational study. Endometrial thickness, structure and echogenicity were recorded. Pulsatility index (PI) and resistive index (RI) of the spiral artery were measured by transvaginal CDS. Endometrial sampling was performed for all subjects. Sonographic and hystopathologic findings were compared. Results: The histopathological diagnoses were as follows; 39 cases (40.2%) endometrial polyp, 9 cases (9.3%) endometrial hyperplasia, 10 cases (10.3) submucous myoma, 7 cases (7.2%) endometrium cancer, and 32 cases (33%) nonspecific findings. The spiral artery PI in endometrium cancer group was highly significantly lower than other groups (p

References

  • Chan FY, Chau MT, Pun TC, et al. Limitations of transvagi- nal sonography and color Doppler imaging in the differ- entiation of endometrial carcinoma from benign lesions. J Ultrasound Med 1994;13:623-628.
  • Kanat-Pektas M, Gungor T, Mollamahmutoglu L. The evalu- ation of endometrial tumors by transvaginal and Doppler ultrasonography. Arch Gynecol Obstet 2008;277:495-499.
  • Epstein E, Skoog L, Isberg PE, et al. An algorithm includ- ing results of gray-scale and power Doppler ultrasound examination to predict endometrial malignancy in women with postmenopausal bleeding. Ultrasound Obstet Gynecol 2002;20:370–376.
  • Develioglu OH, Bilgin T, Yalcin OT, Ozalp S. Transvaginal ultrasonography and uterine artery Doppler in diagnosis endometrial pathologies and carcinoma in postmenopausal bleeding. Arch Gynecol Obstet 2003;268:175-180.
  • Wilailak S, Jirapinyo M, Theppisai U. Transvaginal Doppler sonography: is there a role for this modality in the evalu- ation of women with postmenopausal bleeding? Maturita 2005;50:111-116.
  • Wilczak M, Samulak D, Englert-Golon M, Pieta B. Clinical usefulness of evaluation of quality parameters of blood flow: pulsation index and resistance index in the uterine arteries in the initial differential diagnostics of pathology within the endometrium. Eur J Gyneacol Oncol 2010;31:437-439.
  • Ng EH, Chan CC, Tang OS, et al. Endometrial and subendo- metrial blood flow measured during early luteal phase by three-dimensional Power Doppler ultrasound in excessive ovarian responders. Hum Reprod 2004;19:924-931.
  • Arslan M, Erdem A, Erdem M, et al. Transvaginal color Dop- pler ultrasonography for the prediction of precancerous en- dometrial lesions. Int J Gynecol Obstet 2003;80:299-306.
  • Gull B, Carlsson S, Karlsson B, et al. Transvaginal ultraso- nography of the endometrium in women with postmeno- pausal bleeding: is it always necessary to perform an endo- metrial biopsy? Am J Obstet Gynecol 2000;182:509-515.
  • Briley M, Lindsell DR. The role of transvaginal ultrasound in the investigation of women with post-menopausal bleed- ing. Clin Radiol 1998;53:502–505.
  • Sladkevicius P, Valentin L, Marsal K. Endometrial thick- ness and Doppler velocimetry of the uterine arteries as dis- criminators of endometrial status in women with postmeno- pausal bleeding: a comparative study. Am J Obstet Gynecol 1994;171:722-728.
  • Conoscenti G, Meir YJ, Fischer-Tamaro L, et al. Endome- trial assessment by transvaginal sonography and histologi- cal findings after D & C in women with postmenopausal bleeding. Ultrasound Obstet Gynecol 1995;6:108-115.
  • Amit A, Weiner Z, Ganem N, et al. The diagnostic value of power Doppler measurements in the endometrium of women with postmenopausal bleeding. Gynecol Oncol 2000;77:243-247.
  • Bezircioglu I, Baloglu A, Cetinkaya B, et al. The diagnostic value of the Doppler ultrasonography in distinguishing the endometrial malignancies in women with postmenopausal bleeding. Arch Gynecol Obstet 2012;285:1369-1374.
  • Ng EH, Chan CC, Tang OS, et al. Relationship between uterine blood flow and endometrial and subendometrial blood flows during stimulated and natural cycles. Fertil Steril 2006;85:721-727.
  • Haliloglu B, Celik A, Ilter E, et al. Comparison of uterine artery blood flow with levonorgestrel intrauterine system and copper intrauterine device. Contraception 2011;83:578- 581.
  • Dane B, Akca A, Dane C, et al. Comparison of the effects of the levonorgestrel-releasing intrauterine system (Mi- rena) and depot-medroxyprogesterone acetate (Depo-Pro- vera) on subendometrial microvascularisation and uterine artery blood flow. Eur J Contracept Reprod Health Care 2009;14:240-244.
  • Jiménez MF, Arbo E, Vetori D, et al. The effect of the le- vonorgestrel-releasing intrauterine system and the copper intrauterine device on subendometrial microvascularization and uterine artery blood flow. Fertil Steril 2008;90:1574- 1578.
  • Dragojevic S, Mitrovic A, Dikic S, Canovic F. The role of transvaginal colour Doppler sonography in evalua- tion of abnormal uterine bleeding. Arch Gynecol Obstet 2005;271:332–335.
  • Epstein E, Valentin L. Gray-scale ultrasound morphology in the presence or absence of intrauterine fluid and vas- cularity as assessed by color Doppler for discrimination between benign and malignant endometrium in women with postmenopausal bleeding. Ultrasound Obstet Gynecol 2006;28:89-95.
  • Alcazar JL, Castillo G, Minguez JA , Galan MJ. Endome- trial blood flow mapping using transvaginal power Dop- pler sonography in women with postmenopausal bleeding and thickened endometrium. Ultrasound Obstet Gynecol 2003;21:583-588.
  • Opolskiene G, Sladkevicius P and Valentin L. Ultrasound assessment of endometrial morphology and vascularity to predict endometrial malignancy in women with postmeno- pausal bleeding and sonographic endometrial thickness ≥4.5 mm. Ultrasound Obstet Gynecol 2007;30:332-340.
  • Cil A.P, Tulunay G, Kose MF, Haberal A. Power Dop- pler properties of endometrial polyps and submucosal fi- broids: a preliminary observational study in women with known intracavitary lesions. Ultrasound Obstet Gynecol 2010;35:233-237.
  • Samulak D, Wilczak M, Englert-Golon M, Michalska MM. The diagnostic value of evaluating the maximum velocity of blood flow in the uterine arteries of women with post- menopausal bleeding. Arch Gynecol Obstet 2011;284:1175- 1178.
  • Englert-Golon M, Szpurek D, Moszyński R, et al. Clinical value of the measurement of blood flow in uterine arter- ies and endometrial vessels in women with postmenopausal bleeding using “power” angio Doppler technique. Ginekol Pol 2006;77:759-763.
  • Weiner Z, Beck D, Rottem S, et al. Uterine artery flow ve- locity waveforms and color flow imaging in women with perimenopausal and postmenopausal bleeding. Correlation to endometrial histopathology. Acta Obstet Gynecol Scand 1993;72:162-166.
  • Kurjak A, Shalan H, Sosic A, et al. Endometrial carcino- ma in postmenopausal women: evaluation by transvagi- nal color Doppler ultrasonography. Am J Obstet Gyncol 1993;169:1597-1603.

Endometrial patolojileri öngörmede transvajinal renkli Doppler ultrasonografi ile belirlenen spiral arter akım değişikliklerinin katkısı

Year 2013, Volume: 40 Issue: 3, 345 - 349, 01.09.2013
https://doi.org/10.5798/diclemedj.0921.2013.03.0287

Abstract

Amaç: Endometrial patolojilerin değerlendirilmesinde transvajinal renkli Doppler ultrasonografi (RDU) ile spiral arter akım parametrelerinin katkısını araştırmak. Yöntemler: Anormal uterin kanama ile başvurmuş ve endometrial değerlendirme ihtiyacı olan 97 hastanın katıldığı prospektif gözlemsel bir çalışmadır. Endometrial kalınlık, yapı ve ekojenite kaydedildi. Transvajinal RDU ile spiral arter pulsatilite indeksi (Pİ) ve rezistif indeksi (Rİ) ölçüldü. Tüm olgulara endometrial örnekleme yapıldı. Ultrasonografik ve histopatolojik bulgular karşılaştırıldı. Bulgular: Histopatolojik tanılar; 39 olgu (%40,2) endometrial polip, 9 olgu (%9,3) endometrial hiperplazi, 10 olgu (%10,3) submuköz myom, 7 olgu (%7,2) endometrium kanseri, 32 olgu (%33) nonspesifik bulgular. Endometrial kanser olgularında spiral arter Pİ istatistiksel olarak yüksek anlamlılıkta düşük bulundu (p

References

  • Chan FY, Chau MT, Pun TC, et al. Limitations of transvagi- nal sonography and color Doppler imaging in the differ- entiation of endometrial carcinoma from benign lesions. J Ultrasound Med 1994;13:623-628.
  • Kanat-Pektas M, Gungor T, Mollamahmutoglu L. The evalu- ation of endometrial tumors by transvaginal and Doppler ultrasonography. Arch Gynecol Obstet 2008;277:495-499.
  • Epstein E, Skoog L, Isberg PE, et al. An algorithm includ- ing results of gray-scale and power Doppler ultrasound examination to predict endometrial malignancy in women with postmenopausal bleeding. Ultrasound Obstet Gynecol 2002;20:370–376.
  • Develioglu OH, Bilgin T, Yalcin OT, Ozalp S. Transvaginal ultrasonography and uterine artery Doppler in diagnosis endometrial pathologies and carcinoma in postmenopausal bleeding. Arch Gynecol Obstet 2003;268:175-180.
  • Wilailak S, Jirapinyo M, Theppisai U. Transvaginal Doppler sonography: is there a role for this modality in the evalu- ation of women with postmenopausal bleeding? Maturita 2005;50:111-116.
  • Wilczak M, Samulak D, Englert-Golon M, Pieta B. Clinical usefulness of evaluation of quality parameters of blood flow: pulsation index and resistance index in the uterine arteries in the initial differential diagnostics of pathology within the endometrium. Eur J Gyneacol Oncol 2010;31:437-439.
  • Ng EH, Chan CC, Tang OS, et al. Endometrial and subendo- metrial blood flow measured during early luteal phase by three-dimensional Power Doppler ultrasound in excessive ovarian responders. Hum Reprod 2004;19:924-931.
  • Arslan M, Erdem A, Erdem M, et al. Transvaginal color Dop- pler ultrasonography for the prediction of precancerous en- dometrial lesions. Int J Gynecol Obstet 2003;80:299-306.
  • Gull B, Carlsson S, Karlsson B, et al. Transvaginal ultraso- nography of the endometrium in women with postmeno- pausal bleeding: is it always necessary to perform an endo- metrial biopsy? Am J Obstet Gynecol 2000;182:509-515.
  • Briley M, Lindsell DR. The role of transvaginal ultrasound in the investigation of women with post-menopausal bleed- ing. Clin Radiol 1998;53:502–505.
  • Sladkevicius P, Valentin L, Marsal K. Endometrial thick- ness and Doppler velocimetry of the uterine arteries as dis- criminators of endometrial status in women with postmeno- pausal bleeding: a comparative study. Am J Obstet Gynecol 1994;171:722-728.
  • Conoscenti G, Meir YJ, Fischer-Tamaro L, et al. Endome- trial assessment by transvaginal sonography and histologi- cal findings after D & C in women with postmenopausal bleeding. Ultrasound Obstet Gynecol 1995;6:108-115.
  • Amit A, Weiner Z, Ganem N, et al. The diagnostic value of power Doppler measurements in the endometrium of women with postmenopausal bleeding. Gynecol Oncol 2000;77:243-247.
  • Bezircioglu I, Baloglu A, Cetinkaya B, et al. The diagnostic value of the Doppler ultrasonography in distinguishing the endometrial malignancies in women with postmenopausal bleeding. Arch Gynecol Obstet 2012;285:1369-1374.
  • Ng EH, Chan CC, Tang OS, et al. Relationship between uterine blood flow and endometrial and subendometrial blood flows during stimulated and natural cycles. Fertil Steril 2006;85:721-727.
  • Haliloglu B, Celik A, Ilter E, et al. Comparison of uterine artery blood flow with levonorgestrel intrauterine system and copper intrauterine device. Contraception 2011;83:578- 581.
  • Dane B, Akca A, Dane C, et al. Comparison of the effects of the levonorgestrel-releasing intrauterine system (Mi- rena) and depot-medroxyprogesterone acetate (Depo-Pro- vera) on subendometrial microvascularisation and uterine artery blood flow. Eur J Contracept Reprod Health Care 2009;14:240-244.
  • Jiménez MF, Arbo E, Vetori D, et al. The effect of the le- vonorgestrel-releasing intrauterine system and the copper intrauterine device on subendometrial microvascularization and uterine artery blood flow. Fertil Steril 2008;90:1574- 1578.
  • Dragojevic S, Mitrovic A, Dikic S, Canovic F. The role of transvaginal colour Doppler sonography in evalua- tion of abnormal uterine bleeding. Arch Gynecol Obstet 2005;271:332–335.
  • Epstein E, Valentin L. Gray-scale ultrasound morphology in the presence or absence of intrauterine fluid and vas- cularity as assessed by color Doppler for discrimination between benign and malignant endometrium in women with postmenopausal bleeding. Ultrasound Obstet Gynecol 2006;28:89-95.
  • Alcazar JL, Castillo G, Minguez JA , Galan MJ. Endome- trial blood flow mapping using transvaginal power Dop- pler sonography in women with postmenopausal bleeding and thickened endometrium. Ultrasound Obstet Gynecol 2003;21:583-588.
  • Opolskiene G, Sladkevicius P and Valentin L. Ultrasound assessment of endometrial morphology and vascularity to predict endometrial malignancy in women with postmeno- pausal bleeding and sonographic endometrial thickness ≥4.5 mm. Ultrasound Obstet Gynecol 2007;30:332-340.
  • Cil A.P, Tulunay G, Kose MF, Haberal A. Power Dop- pler properties of endometrial polyps and submucosal fi- broids: a preliminary observational study in women with known intracavitary lesions. Ultrasound Obstet Gynecol 2010;35:233-237.
  • Samulak D, Wilczak M, Englert-Golon M, Michalska MM. The diagnostic value of evaluating the maximum velocity of blood flow in the uterine arteries of women with post- menopausal bleeding. Arch Gynecol Obstet 2011;284:1175- 1178.
  • Englert-Golon M, Szpurek D, Moszyński R, et al. Clinical value of the measurement of blood flow in uterine arter- ies and endometrial vessels in women with postmenopausal bleeding using “power” angio Doppler technique. Ginekol Pol 2006;77:759-763.
  • Weiner Z, Beck D, Rottem S, et al. Uterine artery flow ve- locity waveforms and color flow imaging in women with perimenopausal and postmenopausal bleeding. Correlation to endometrial histopathology. Acta Obstet Gynecol Scand 1993;72:162-166.
  • Kurjak A, Shalan H, Sosic A, et al. Endometrial carcino- ma in postmenopausal women: evaluation by transvagi- nal color Doppler ultrasonography. Am J Obstet Gyncol 1993;169:1597-1603.
There are 27 citations in total.

Details

Primary Language Turkish
Journal Section Research Articles
Authors

Suna Kabil Kucur This is me

Alev Atış Aydın This is me

Osman Temizkan This is me

İlay Gözükara This is me

Eda Ülkü Uludağ This is me

Canan Acar This is me

İnci Davas This is me

Publication Date September 1, 2013
Submission Date March 2, 2015
Published in Issue Year 2013 Volume: 40 Issue: 3

Cite

APA Kucur, S. K., Aydın, A. A., Temizkan, O., Gözükara, İ., et al. (2013). Endometrial patolojileri öngörmede transvajinal renkli Doppler ultrasonografi ile belirlenen spiral arter akım değişikliklerinin katkısı. Dicle Medical Journal, 40(3), 345-349. https://doi.org/10.5798/diclemedj.0921.2013.03.0287
AMA Kucur SK, Aydın AA, Temizkan O, Gözükara İ, Uludağ EÜ, Acar C, Davas İ. Endometrial patolojileri öngörmede transvajinal renkli Doppler ultrasonografi ile belirlenen spiral arter akım değişikliklerinin katkısı. diclemedj. September 2013;40(3):345-349. doi:10.5798/diclemedj.0921.2013.03.0287
Chicago Kucur, Suna Kabil, Alev Atış Aydın, Osman Temizkan, İlay Gözükara, Eda Ülkü Uludağ, Canan Acar, and İnci Davas. “Endometrial Patolojileri öngörmede Transvajinal Renkli Doppler Ultrasonografi Ile Belirlenen Spiral Arter akım değişikliklerinin katkısı”. Dicle Medical Journal 40, no. 3 (September 2013): 345-49. https://doi.org/10.5798/diclemedj.0921.2013.03.0287.
EndNote Kucur SK, Aydın AA, Temizkan O, Gözükara İ, Uludağ EÜ, Acar C, Davas İ (September 1, 2013) Endometrial patolojileri öngörmede transvajinal renkli Doppler ultrasonografi ile belirlenen spiral arter akım değişikliklerinin katkısı. Dicle Medical Journal 40 3 345–349.
IEEE S. K. Kucur, A. A. Aydın, O. Temizkan, İ. Gözükara, E. Ü. Uludağ, C. Acar, and İ. Davas, “Endometrial patolojileri öngörmede transvajinal renkli Doppler ultrasonografi ile belirlenen spiral arter akım değişikliklerinin katkısı”, diclemedj, vol. 40, no. 3, pp. 345–349, 2013, doi: 10.5798/diclemedj.0921.2013.03.0287.
ISNAD Kucur, Suna Kabil et al. “Endometrial Patolojileri öngörmede Transvajinal Renkli Doppler Ultrasonografi Ile Belirlenen Spiral Arter akım değişikliklerinin katkısı”. Dicle Medical Journal 40/3 (September 2013), 345-349. https://doi.org/10.5798/diclemedj.0921.2013.03.0287.
JAMA Kucur SK, Aydın AA, Temizkan O, Gözükara İ, Uludağ EÜ, Acar C, Davas İ. Endometrial patolojileri öngörmede transvajinal renkli Doppler ultrasonografi ile belirlenen spiral arter akım değişikliklerinin katkısı. diclemedj. 2013;40:345–349.
MLA Kucur, Suna Kabil et al. “Endometrial Patolojileri öngörmede Transvajinal Renkli Doppler Ultrasonografi Ile Belirlenen Spiral Arter akım değişikliklerinin katkısı”. Dicle Medical Journal, vol. 40, no. 3, 2013, pp. 345-9, doi:10.5798/diclemedj.0921.2013.03.0287.
Vancouver Kucur SK, Aydın AA, Temizkan O, Gözükara İ, Uludağ EÜ, Acar C, Davas İ. Endometrial patolojileri öngörmede transvajinal renkli Doppler ultrasonografi ile belirlenen spiral arter akım değişikliklerinin katkısı. diclemedj. 2013;40(3):345-9.