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Overall Sensitivity for Endometrial Polyps 89% With Color Doppler


 

Disclosures: Dr. Chang said she had no relevant financial disclosures.

KISSIMMEE, FLA. — Color Doppler imaging is highly sensitive for endometrial polyps, because it can identify the feeding vessel that allows the polyp to grow, according to Dr. Pauline L. Chang.

A retrospective study of 74 women found that color Doppler had an overall sensitivity of 89% and a positive predictive value of 80% for endometrial polyps. Among only premenopausal women, the sensitivity was even better at 96%, she said at the annual meeting of the AAGL.

In fact, said Dr. Chang of Stanford (Calif.) University, the test's diagnostic values are so good that a positive color Doppler should eliminate the need for second-line testing.

“For women with a positive transvaginal color Doppler, additional imaging, such as saline-infusion sonohysterography, is not necessary for confirmation before proceeding to definitive management with hysteroscopy,” she said.

All 74 of the women in the study had undergone a transvaginal pelvic sonogram that suggested endometrial polyps. However, color Doppler imaging revealed vascularity in 64 patients, and hysteroscopy confirmed this finding in 51 of them.

There were 13 false-positive results, which hysteroscopy confirmed as normal in five women, fibroids in seven, and a dense adhesion in one Thus, Dr. Chang said, “vascularity on Doppler imaging had a sensitivity of 89.5% and a positive predictive value of 80% for detection of endometrial polyps.”

Dr. Chang then divided the group into premenopausal and postmenopausal women. For the 61 premenopausal women who had evidence of endometrial polyps on transvaginal ultrasound, color Doppler found vascularity in 55; there were 11 false positives confirmed by hysteroscopy. For this group, the sensitivity of color Doppler for endometrial polyps was 96%, and the positive predictive value was 80%.

In the group of 13 menopausal women, color Doppler identified 9 with vascular polyps; there were two false positives, Dr. Chang reported. For the menopausal group, Doppler had a sensitivity of 67% and a 78% positive predictive value.

A focal abnormality on grayscale ultrasound suggests an endometrial polyp.

Color Doppler reveals vascularity, increasing the suspicion of a polyp.

Source Images courtesy Dr. Pauline L. Chang

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