Endometrial carcinoma in postmenopausal women: evaluation by transvaginal color Doppler ultrasonography

This study was conducted to evaluate the role of transvaginal color Doppler ultrasonography in detecting endometrial carcinoma in postmenopausal women and in evaluating the depth of myometrial invasion and tumor staging.

A group of 750 postmenopausal women were examined by transvaginal color Doppler ultrasonography 1 day before the planned hysterectomy. Histopathologic and blood flow characteristics were evaluated. Analysis of variance was used to test the significance among the subgroups.

Thirty-five women had endometrial carcinoma; 32 (91.4%) cases were detected by transvaginal color Doppler ultrasonography. Visualization of abnormal blood flow within the endometrium was 100% in the diagnosed cases with resistance index near or < 0.40, which constituted a statistically significant difference compared with that of endometrial hyperplasia. No flow was detected in normal, atrophic, and in 92% of cases with hyperplastic endometria. The color Doppler ultrasonography depicted 18 of 19 histologically proved cases of myometrial invasion. Three asymptomatic cases were discovered on the basis of morphologic and blood flow patterns.

Transvaginal color Doppler ultrasonography can depict endometrial carcinoma, even in asymptomatic women, determine the depth of myometrial invasion, and help in tumor staging.