الفهرس 
INTRODUCTIONOnly 14 pages are availabe for public view
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Abstract
US is the modality of choice for the initial imaging evaluation of female pelvic organs. US is widely available in many regions of the world, is relatively inexpensive, is noninvasive, and does not use ionizing radiation. Typical examinations include transabdominal sonography (TAS) and transvaginal sonography (TVS), which are supplemented by color Doppler imaging as needed.
TAS gives an overview of the female pelvis including the uterus, parametrial region as well as the adnexa.
TVS has the advantage of using high-frequency transducers that are placed close to the regions of interest and produce high-resolution images of significantly better quality than transabdominal images. While both TAS and TVS allow visualization of the endometrium, exquisitely finer endometrial details are possible to depict transvaginally rather than transabdominally.
The aim of the work is to demonstrate the role of transabdominal, transvaginal and Doppler mapping in detection and characterization of pathologic endometrium.
The study included 50 patients with different gynecological complaints referred to Alexandria University Hospital from the gynecology department for radiological examination after exclusion of pregnant females and virgins.
These patients were subjected to detailed history taking including the medical and drug history as well as thorough clinical examination with emphasis on the gynecological system. Further sonography (TAS and TVS) was performed in all patients coupled with Doppler mapping on both techniques.
Pathologies identified among the premenopausal (29/50) and postmenopausal (21/50) groups were categorized as either endometrial (33/50) or subendometrial (17/50) pathologies.
Endometrial pathologies were further subdivided into focal ,diffuse and combined focal and diffuse pathologies. where 12/33 patients had focal endometrial pathologies ;9/12 cases (77%) were found among the premenopausal group and 3/12 cases (23%) were found among the postmenopausal group. While 19/33 patients had diffuse endometrial pathologies; 16/19 of which were found among the postmenopausal group and 3/19 of which were found among the premenopausal group. The remaining 2/33 patients had combined focal and diffuse pathologies and were found among the premenopausal age group.
Focal endometrial pathologies(12/33) were in the form of 11/12 cases of polyps ( uterine or cervical ) where lesions were either sessile or pedunculated in nature showing predominantly iso to hyperechoic texture . The remaining 1/12 cases was diagnosed as uterine blood clot.
Among the diffuse endometrial pathologies ( 19/33) , 2 cases did not undergo D&C or endometrial biopsy due to uncontrolled coagulopathy. Thus, the remaining 17 patients were diagnosed as endometrial hyperplasia (7/17), endometrial carcinoma (4/17), proliferative endometrium (2/17), disordered proliferative endometrium (3/17) and choriocarcinoma (1/17).
Cases of endometrial hyperplasia showed diffusely thickened homogenous endometrium with intact endometrial–myometrial interface and showed No Doppler signal on Doppler mapping. Endometrial carcinoma was suspected in cases of heterogeneously thickened pathological endometrium with positive Doppler signal detected within the pathologically thickened endometrium which was associated with interruption of the endometrial–myometrial interface in 2/4 cases in the group.