Correlation of the role of Transvaginal Sonography and Doppler with endometrial biopsy in detection of carcinoma endometrium in postmenopausal bleeding

ABSTRACT To evaluate the diagnostic accuracy of transvaginal sonography (TVS) with Doppler compared to histopathological examination in diagnosing endometrial pathology in patients with postmenopausal bleeding; to determine whether the number of diagnostic dilatation and curettage (invasive) can be reduced by TVS (non-invasive) examination. 100 women were selected by Simple Random Sampling method, satisfying the inclusion criteria from January 2015 to June 2016. After obtaining written informed consent and detailed clinical examination TVS with doppler followed by dilatation and curettage were done and specimen were sent for histopathological examination. Patients with postmenopausal bleeding were included and those on Hormone Replacement Therapy, with bleeding disorders, known cases of malignancies, cervical polyp were excluded from the study. Statistical analysis was done for these parameters. TVS with Doppler parameters had sensitivity of 72.92% and specificity of 57.69% as a diagnostic tool in order to detect endometrial hyperplasia and endometrial carcinoma in such patients. It had a positive predictive value of 61.40% and negative predictive value of 69.77% with capability of diagnosing endometrial pathology with an accuracy of 65%. 48 patients had endometrial atrophy. There is a high incidence of endometrial atrophy in patients presenting with postmenopausal bleeding. The relatively good sensitivity and accuracy of TVS with doppler in detection of endometrial pathology encourage us to suggest that it can be utilized as a first line investigation in these patients to rule out endometrial hyperplasia or endometrial cancer. Keywords: Transvaginal Sonography, doppler, postmenopausal bleeding, endometrial pathology or cancer