Role of endometrial power Doppler ultrasound using the international endometrial tumor analysis group classification in predicting intrauterine pathology

Purpose

To assess the contribution of the terms and definitions recently described by international endometrial tumor analysis (IETA) group when evaluating endometrial lesions on power Doppler imaging.

Methods

Patients requiring endometrial sampling were examined prospectively by transvaginal B-mode and power Doppler sonography (PDS) the day before scheduled diagnostic procedure. Sonographic features were classified using IETA group classification. These were compared with the final histopathological diagnosis.

Results

Ninety-seven patients were included in the study. The histopathological diagnoses were as follows: endometrial polyp: 39 cases (40.2 %), endometrial hyperplasia: 9 cases (9.3 %), submucous myoma: 10 cases (10.3 %), endometrium cancer: 7 cases (7.2 %), non-specific findings: 32 cases (33 %). The sensitivity, specificity and positive and negative predictive values for single dominant or branching single dominant vessel pattern in diagnosing endometrial polyps were 66.67, 98.28, 96.3 and 81.43 %; for multiple vessels with focal origin pattern in diagnosing endometrial cancer, they were 42.86, 91.11, 27.27 and 95.35 %; for multifocal origin at the myometrial–endometrial junction in diagnosing other non-specific endometria, they were 81.25, 89.23, 78.79 and 90.62 %; for scattered vessel pattern in diagnosing endometrial hyperplasia, they were 88.89, 88.64, 44.4 and 98.73 % and for circular flow pattern in diagnosing submucosal fibroids, they were 80, 100, 100 and 97.75 %, respectively. The color score of the endometrium was not statistically different among different endometrial pathologies (P value >0.05).

Conclusion

The nomenclature described by IETA group for power Doppler assessment of the endometrium is clinically valuable and reasonable. Using this terminology, it will be easier to compare results of different studies on endometrial Doppler sonography in the future.