Color Doppler velocimetry of the uterine and ovarian arteries in dysfunctional uterine bleeding with histopathological correlation

Objective: To evaluate like accuracy of transvaginal color Doppler ultrasonography of the ovarian and uterine arteries for diagnosis and differentiation of various endometrial patterns in cases with dysfunctional uterine bleeding (DUB) and correlate such findings with the histopathology of the endometrium. Setting: Obst. & Gyn. Dept., Al-Azhar Univ. Hospitals, Cairo, Egypt. Design: A comparative prospective controlled study. Patients and Method: 75 female patients were selected for this study whose age ranging from 30-45 years old and classified to 2 groups. A study group; 50 patients complaining of abnormal uterine bleeding without demonstrable organic pelvic pathology and a control group; 25-volunteers with normal menstrual pattern and no abnormality that would affect the vascularity of the pelvis (these cases complaining of infertility which proved to be male factor and ethical consent was confirmed). Transvaginal color Doppler was used for assessment of (RI) of the left ascending uterine and intraovarian arteries were done at any time in the study group and in the midluteal phase in tie control group. Endometrial thickness was also measured during ultrasonographic examination in relation to the histopathological types of endometrium which was obtained by full curettage to the study group and endometrial biopsy to the control one. Results: The mean age for the study group was 37.6 +/- 3.74, while, that for the control group was 35.9 +/- 7.82. In comparing the values of uterine artery RI, ovarian RI, and endometrial thickness of the study and control groups there were statistical significant differences except for the cases with atrophic endometrium which was statistically insignificance as regards uterine RI. Conclusion: This study recommended the use of transvaginal ultra sonographic examination to measure the endometrial thickness, combined with Doppler velocimetry RI of the uterine and ovarian arteries as non invasive diagnostic tool for all cases with dysfunction uterine bleeding.