Lieng M, Qvigstad E, Dahl G F, Istre O
Department of Gynecology and Obstetrics, Ullevål University Hospital, Oslo, Norway.
Ultrasound Obstet Gynecol. 2008 Dec;32(7):935-40. doi: 10.1002/uog.6267.
To evaluate whether assessment of blood flow by transvaginal color Doppler and three-dimensional power Doppler imaging, enhanced by intravenous contrast, may be useful in the differentiation between benign endometrial polyps and endometrial cancer.
A prospective study was performed comparing 17 women with benign endometrial polyps and 17 women with endometrial cancer. Transvaginal color Doppler and three-dimensional power Doppler angiography were performed before and after injection of intravenous contrast. The pulsatility index (PI) and the resistance index (RI) of the polyp feeding vessel or central vessel in malignant lesions, as well as the power Doppler endometrial flow indices vascularization index (VI), flow index (FI) and vascularization flow index (VFI), were calculated before and after enhancement by contrast, and compared between the two groups of women.
PI (mean difference +/- SD, 0.68 +/- 0.22; 95% CI, 0.23-1.13; P = 0.004) and RI (mean difference +/- SD, 0.16 +/- 0.08; 95% CI, 0.00-0.32; P = 0.045) were significantly lower in vessels of malignant tumors than in those of benign endometrial polyps after enhancement by intravenous contrast. No significant differences in PI, RI, VI, FI or VFI before enhancement by contrast, or in VI, FI or VFI after enhancement by contrast, were detected between women with endometrial polyps and those with endometrial cancer.
Transvaginal color Doppler examination enhanced by intravenous contrast may help to discriminate between benign endometrial polyps and cancer. Larger studies are required to confirm these findings.
评估经阴道彩色多普勒和三维能量多普勒成像联合静脉造影评估血流情况，是否有助于鉴别良性子宫内膜息肉和子宫内膜癌。
进行一项前瞻性研究，比较17例患有良性子宫内膜息肉的女性和17例患有子宫内膜癌的女性。在静脉注射造影剂前后分别进行经阴道彩色多普勒和三维能量多普勒血管造影。计算恶性病变中息肉供血血管或中心血管的搏动指数（PI）和阻力指数（RI），以及造影剂增强前后两组女性的能量多普勒子宫内膜血流指数血管化指数（VI）、血流指数（FI）和血管化血流指数（VFI），并进行比较。
静脉注射造影剂增强后，恶性肿瘤血管的PI（平均差值±标准差，0.68±0.22；95%可信区间，0.23 - 1.13；P = 0.004）和RI（平均差值±标准差，0.16±0.08；95%可信区间，0.00 - 0.32；P = 0.045）显著低于良性子宫内膜息肉血管。在造影剂增强前，子宫内膜息肉患者和子宫内膜癌患者之间的PI、RI、VI、FI或VFI，以及造影剂增强后的VI、FI或VFI均未检测到显著差异。
静脉造影增强的经阴道彩色多普勒检查可能有助于鉴别良性子宫内膜息肉和癌症。需要更大规模的研究来证实这些发现。
