Three-dimensional ultrasound imaging for discrimination between benign and malignant endometrium in women with postmenopausal bleeding and sonographic endometrial thickness of at least 4.5 mm.

摘要: OBJECTIVES: To determine whether endometrial volume or power Doppler indices as measured by three-dimensional (3D) ultrasound imaging can discriminate between benign and malignant endometrium, to compare their diagnostic performance with that of thickness measurement using two-dimensional (2D) examination, add any information volume. METHODS: Sixty-two patients postmenopausal bleeding >/= 4.5 mm underwent transvaginal 2D gray-scale 3D examination the corpus uteri. The was calculated, along vascularization index (VI), flow (VFI) in endometrium a 2-mm 'shell' surrounding endometrium. 'gold standard' histological diagnosis obtained hysteroscopic resection focal lesions, dilatation curettage hysterectomy. Receiver-operating characteristics (ROC) curves were drawn for all measurements evaluate ability distinguish Multivariate logistic regression analysis used create mathematical models estimate risk malignancy. RESULTS: There 49 13 endometria. Endometrial significantly larger than endometria, shell higher. area under ROC curve (AUC) 0.82, 0.78, two best variables (VI VFI endometrium) 0.82 0.82. model predicting malignancy contained (odds ratio 1.2; 95% CI, 1.04-1.30; P = 0.004) VI 1.1; 1.02-1.23; 0.01). Its AUC 0.86. Using its mathematically optimal cut-off value (0.22), correctly classified seven more cases but fewer (11.8 mm). Models containing performed less well did alone (AUC, 0.79 vs. 0.82). CONCLUSIONS: discrimination not superior added little Copyright (c) 2009 ISUOG. Published John Wiley & Sons, Ltd. (Less)