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Power doppler versus saline infusion sonography in the diagnosis of endometrial polyps in patients who present with abnormal uterine bleeding

Sepide Nematian, MD, FPOGS; Marlyn T. Dee, MD, FPOGS; Leah N. Rivera, MD, FPOGS
Department of Obstetrics and Gynecology, University of Santo Tomas Hospital

Objective: To compare the diagnostic performance of Power Doppler versus Saline Infusion Sonography (SIS) in the diagnosis of endometrial polyps in patients who present with abnormal uterine bleeding using histopathological confirmation.

Methods: This is a 2-year cohort study involving non-pregnant patients with abnormal uterine bleeding examined prospectively and subjected to both transvaginal sonography with power Doppler and SIS. Single-vessel pattern/comma-like patterns on power Doppler were considered positive. Results were compared to the gold standard histopathological examination obtained by
endometrial biopsy, curettage, or hysteroscopic resection of endometrial polyp.

Results: A total of 42 patients completed the study and were included in the final analysis. Thirty-five (35) patients had confirmed endometrial polyp by histopathology. Power Doppler was positive in 32 of these patients. SIS, on the other hand was positive in 16 patients. The results are as follows: sensitivity 89%, specificity 83%, and positive and negative predictive values 97% and 56% respectively for power Doppler. For SIS, on the other hand, sensitivity 46%, specificity 86%, positive and negative predictive values of 94% and 24% respectively.

Conclusion: Power Doppler is as useful in identifying patients with endometrial polyps and can be used in place of the traditional test SIS. Its diagnostic accuracy is better than SIS.

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