Sladkevicius P, Valentin L, Marsál K
Department of Obstetrics and Gynecology, Lund University, General Hospital, Malmö, Sweden.
Am J Obstet Gynecol. 1994 Sep;171(3):722-8. doi: 10.1016/0002-9378(94)90088-4.
Our purpose was to compare the ability of transvaginal Doppler ultrasonographic examination with that of gray-scale ultrasonographic examination to discriminate between benign and malignant and between normal and pathologic endometrium in women with postmenopausal bleeding.
One hundred thirty-eight consecutive women scheduled for curettage because of postmenopausal bleeding underwent transvaginal ultrasonography, including color and spectral Doppler techniques, within 8 days preceding the operation. The thickness of the endometrium was measured. Doppler signals of the maximum blood flow velocity obtained from the two main uterine arteries and subendometrial and intraendometrial arteries were evaluated for pulsatility index and time-averaged maximum velocity. The results of the examinations were compared with the histologic diagnosis of the curettage specimen.
Receiver-operator characteristic curves showed endometrial thickness to be a better discriminator between normal and pathologic and between benign and malignant endometrium than any Doppler variable, 14 mm being the optimal threshold value for differentiating between benign and malignant endometrium (sensitivity 88%, specificity 81%).
Measurement of endometrial thickness with transvaginal ultrasonography is a better method for discriminating between benign and malignant or normal and pathologic endometrium than is Doppler velocimetry of the uterine arteries.
我们的目的是比较经阴道多普勒超声检查与灰阶超声检查在鉴别绝经后出血女性良性与恶性子宫内膜以及正常与病理子宫内膜方面的能力。
138例因绝经后出血计划行刮宫术的连续女性在手术前8天内接受经阴道超声检查，包括彩色和频谱多普勒技术。测量子宫内膜厚度。评估从两条主要子宫动脉以及子宫内膜下和子宫内膜内动脉获得的最大血流速度的多普勒信号的搏动指数和时间平均最大速度。将检查结果与刮宫标本的组织学诊断进行比较。
受试者工作特征曲线显示，与任何多普勒变量相比，子宫内膜厚度在区分正常与病理以及良性与恶性子宫内膜方面是更好的鉴别指标，14mm是区分良性与恶性子宫内膜的最佳阈值（敏感性88%，特异性81%）。
经阴道超声测量子宫内膜厚度在鉴别良性与恶性或正常与病理子宫内膜方面比子宫动脉多普勒测速法是更好的方法。
