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Color Doppler Sonohysterography of Endometrial Polyps and Submucosal Fibroids

Departments of Radiology (A.C.F.), Obstetrics and Gynecology (A.C.F.), and Pathology (H.W.S.), Vanderbilt University Medical Center, Nashville, Tennessee USA.

Address correspondence and reprint requests to Arthur C. Fleischer, MD, Department of Radiology, Vanderbilt University Medical Center, RR-1213, Medical Center North, Nashville, TN 37232-2675 USA.

Objective. To describe the typical sonographic findings and clinical applications of color Doppler sonohysterography and to correlate the vascularity of lesions seen on color Doppler sonohysterography to microvessel density and the presence of vessels greater than 0.5 mm. Methods. Color Doppler sonohysterography was performed on 25 women with abnormal uterine bleeding. The vascularity (number of vessels >0.5 mm) and their configuration seen on color Doppler sonohysterography were compared with those obtained on the excised specimen. Microvessel density and histologic features were correlated to the visualization of vessels greater than 0.5 mm and their arrangement on color Doppler sonography. Results. The color Doppler sonographic findings in 18 polyps, 3 submucosal fibroids, and 1 clot showed distinct vascularity patterns. Polyps typically contained a single feeding vessel, whereas fibroids had several vessels, which arose from the inner myometrium. Lesions with higher microvessel density tended to have more vessels greater than 0.5 mm as depicted on color Doppler sonography. Conclusions. Color Doppler sonohysterography may be useful in distinguishing polyps from submucosal fibroids based on the vascularity of the lesions. The number of vessels seen on color Doppler sonography approximates microvessel density within the lesions.

Key Words: color Doppler sonography • endometrial polyps • sonohysterography • submucosal fibroids • vascularity

Abbreviations: CDS, color Doppler sonography • CD-SHG, color Doppler sonohysterography • HPF, high-power field • MVD, microvessel density • SHG, sonohysterography

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