Role of Transvaginal Ultrasonography and Color Doppler in the Assessment of Vaginal Bleeding in Postmenopausal Women | ||
| Suez Canal University Medical Journal | ||
| Article 4, Volume 28, Issue 7, July 2025, Pages 26-34 PDF (334.55 K) | ||
| Document Type: Original Article | ||
| DOI: 10.21608/scumj.2025.440777 | ||
| Authors | ||
| Shaimaa Radwan* 1; Wael Mahmoud Nemattallah2; Ahmed Fathi El Serafi2 | ||
| 1Medical Imaging Department, Ismailia Medical Complex, Ismailia, Egypt | ||
| 2Diagnostic Radiology Department, Faculty of Medicine, Suez Canal University, Ismailia, Egypt | ||
| Abstract | ||
| Background: Postmenopausal bleeding (PMB) is a common clinical issue that raises concerns for serious underlying conditions, including endometrial cancer (EC). Accurate diagnosis is crucial for timely intervention, and imaging techniques like Transvaginal Ultrasonography (TVUS) and Color Doppler Ultrasound (CDUS) are widely used to evaluate the endometrium and uterine blood flow. Aim: This study aims to assess the diagnostic accuracy of TVUS and CDUS in identifying the causes of PMB, with a focus on differentiating between benign and malignant endometrial conditions. Patients and Methods: The study included postmenopausal women presenting with vaginal bleeding. All subjects underwent TVUS to measure endometrial thickness (ET), followed by CDUS to assess blood flow in the uterine spiral arteries. Doppler parameters, including peak systolic velocity (PSV), resistive index (RI), and pulsatility index (PI), were recorded. Histopathological diagnoses from biopsies were used as the reference standard to evaluate the imaging results. Results: Findings revealed that women with endometrial malignancies had significantly higher ET and abnormal Doppler flow parameters compared to benign conditions. ET greater than 5 mm on TVUS strongly indicated pathological findings, and CDUS showed low RI and PI in malignant cases. The combination of TVUS and CDUS improved diagnostic sensitivity (96%) and specificity (92%) for detecting EC and other endometrial abnormalities. Conclusions: TVUS, combined with CDUS, is a highly effective, non-invasive diagnostic approach for evaluating PMB and differentiating between benign and malignant causes. Integrating these techniques into routine clinical practice can enhance early detection of endometrial cancer and reduce unnecessary invasive procedures. | ||
| Keywords | ||
| Endometrial pathology; Uterine blood flow; Non-invasive imaging; Vascular assessment; Postmenopausal diagnostics | ||
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