الفهرس 
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Abstract
Introduction:
Abnormal uterine bleeding (AUB) affects 10 to 30 percent of reproductive-aged women and up to 50 percent of peri-menopausal women
Fibroids or polyps are the most common cause of anatomic AUB. Twenty to forty percent of women have fibroids. These women might present with abnormal uterine bleeding, anemia, pain and occasionally infertility
Power Doppler blood flow mapping is a useful, practical, and noninvasive diagnostic method for the differential diagnosis of benign intrauterine focal lesions. Especially in cases of recurrent abnormal uterine bleeding, recurrent abortion, and infertility, PDUS can be preferred as a first-line diagnostic method
Aim of this study:
To decide the diagnostic accuracy of Power Doppler TVS in detecting benign uterine cavity lesions in cases of perimenopausal bleeding with abnormal uterine bleeding.
Methodology:
96 patients were included in this cross sectional study from those attending the Obstetrics and Gynecology outpatient clinic at Ain shams hospital, they were subjected to Power Doppler TVS to diagnose the endometrial lesion, hysteroscopic examination and finally to histopathological study.
Selection Criteria:
(1) Perimenopausal Age group from 40 to 55 years.
(2) Non pregnant women.
(3) Patients suffering from abnormal uterine bleeding.
(4) Patients that did preliminary ultrasound to exclude adnexal masses
Findings using these tools were compared to each other considering histopathology results to be the gold standard.
Results:
In our study the incidence of all findings using the mentioned interventions were as follows:
The most diagnosed lesion by histopathology is endometrial hyperplasia (50%) of the cases followed by the endometrial polyp(34.4%) then the submucous myoma(15.6%).
Power Doppler TVS diagnosed endometrial hyperplasia in 49% of the cases by scattered vessels pattern , while endometrial polyps are found in 30.2% 0f cases with single vessel pattern and the circular pattern of submucous myomas are found in 15.6% of cases and 5.2% shows non specific vascularity. No endometrial cancer was diagnosed in this study.
For diagnosing endometrial hyperplasia:
Power Doppler TVS has 87.8% sensitivity, 100% specificity and 95.8% accuracy.
For diagnosing endometrial Polyp:
Power Doppler TVS has 97.9% sensitivity, 100% specificity and 98.9% accuracy
For diagnosing submucous myoma:
Power Doppler TVS show 100% sensitivity, 100% specificity and accuracy 100%.
Conclusion:
Power Doppler shows very high accuracy for the diagnosis of endometrial benign intra-cavitary lesions.
Power Doppler ultrasound can be used as the first step, non invasive, safe , easy applied tool in diagnosing benign endometrial causes of abnormal uterine bleeding in perimenopausal women