Power Doppler properties of endometrial polyps and submucosal fibroids: a preliminary observational study in women with known intracavitary lesions

Objectives To compare power Doppler flow mapping characteristics of endometrial polyps and submucosal fibroids and analyze whether two different power Doppler characteristics, single-vessel pattern and rim-like vessel pattern, can help to differentiate these focal endometrial lesions. Methods Patients suspected of having endometrial polyps or submucosal fibroids on sonohysterography were examined prospectively by transvaginal B-mode and power Doppler sonography. Single-vessel pattern and rim-like vessel pattern were considered to be characteristic of endometrial polyps and submucosal fibroids, respectively. Suspected diagnoses of the lesions according to vascular Doppler characteristics were compared with the final diagnosis following histopathological examination. Results Included in the final analysis were 49 patients with histological confirmation of the type of endometrial lesion: 32 with endometrial polyps and 17 with submucosal fibroids. Power Doppler signals were observed in 47 of these; they were not observed in two patients with endometrial polyps. Of the 32 with endometrial polyps, 26 (81.3%) endometrial polyps showed a single-vessel,P pattern, three (9.4%) showed a multiple-vessel pattern and one (3.1%) showed a scattered-vessel pattern. Of the 17 with submucosal fibroids, 12 (70.6%) showed a rim-like vessel pattern, three (17.6%) showed a multiple-vessel pattern and two (11.8%) showed a single-vessel pattern. Single-vessel pattern was associated with two false-positive cases, but there were no false-positive cases for rim-like vessel pattern. The sensitivity, specificity and positive and negative predictive values for single-vessel pattern in diagnosing endometrial polyps were 81.2%, 88.2%, 92.9% and 71.4% and for rim-like pattern in diagnosing submucosal fibroids they were 70.6%, 100%, 100% and 86.5%, respectively. Conclusions Power Doppler blood flow mapping is a valuable tool in the diagnosis of focal endometrial pathology and is useful in distinguishing submucosal fibroids and endometrial polyps. Copyright (C) 2010 ISUOG. Published by John Wiley & Sons, Ltd.