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© 2006 by the American Institute of Ultrasound in Medicine
J Ultrasound Med 25:159-163 • 0278-4297

Reproducibility of Endometrial Vascular Patterns in Endometrial Disease as Assessed by Transvaginal Power Doppler Sonography in Women With Postmenopausal Bleeding

Juan Luis Alcázar, MD, Silvia Ajossa, MD, Stefano Floris, MD, Roberta Bargellini, MD, Marta Gerada, MD and Stefano Guerriero, MD

Department of Obstetrics and Gynecology, Clínica Universitaria de Navarra, University of Navarra, Pamplona, Spain (J.L.A.); and Department of Obstetrics and Gynaecology, Ospedale San Giovanni di Dio, University of Cagliari, Cagliari, Italy (S.A., S.F., R.B., M.G., S.G.).

Address correspondence to Juan Luis Alcázar, MD, Department of Obstetrics and Gynaecology, Clínica Univeristaria de Navarra, Avenida Pio XII 36, 31008 Pamplona, Spain. E-mail: jlalcazar{at}unav.es

Objective. The purpose of this study was to assess the intraobserver and interobserver agreement for identifying different endometrial vascular patterns using power Doppler sonography in women with postmenopausal bleeding and a thickened endometrium. Methods. Digitally stored sonographic images from a random sample of 65 patients with postmenopausal bleeding and a thick endometrium (>5 mm) on B-mode sonography and evaluated by transvaginal power Doppler sonography for assessment of endometrial blood flow mapping were evaluated by 5 different examiners with different levels of expertise in Doppler sonography. Intraobserver and interobserver agreement according to the level of experience were assessed by calculating the {kappa} index. Results. Intraobserver agreement was good or very good for all experienced examiners ({kappa} = 0.78–0.96) and moderate ({kappa} = 0.52) for the inexperienced examiner. Interobserver agreement was moderate among all experienced examiners ({kappa} = 0.45–0.80). The inexperienced examiner showed fair or moderate interobserver agreement ({kappa} = 0.32–0.45). Conclusions. Our results indicate that endometrial blood flow mapping using transvaginal power Doppler sonography is acceptably reproducible. More experience was associated with better intraobserver and interobserver agreement.

Key Words: endometrial disease • power Doppler sonography • reproducibility

Abbreviations: CI, confidence interval

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Copyright © 2006 by the American Institute of Ultrasound in Medicine.