US Duplex Doppler Pelvis Although it is rated as a separate imaging procedure per ACR methodology, this document considers Doppler imaging to be a standard component of pelvic US. Color and spectral Doppler are routinely used in pelvic US examinations to evaluate internal vascularity of pelvic findings and distinguish fluid from vascular soft-tissue. US duplex Doppler evaluation of the vascularity of the endometrium can help identify vessels within endometrial polyps or cancer, or the lack of vascularity in the normal endometrium [30]. Visualization of a vascular pedicle during transvaginal color Doppler imaging has a specificity of 62% to 98% and a negative predictive value of 50% to 94% for the detection of endometrial polyps [34-36]. Currently, investigations are ongoing to evaluate whether color Doppler patterns can differentiate endometrial polyps from endometrial cancer [4,34,37]. The addition of Doppler may improve the sensitivity, specificity, and positive predictive value of US for the diagnosis of adenomyosis [38]. To our knowledge, there is no relevant literature that has assessed vascularity of leiomyomas and leiomyosarcomas in order to differentiate these two entities. US Pelvis Transabdominal A combined transabdominal and transvaginal approach is typically used for pelvic US imaging. Transabdominal US is most helpful in the case of a significantly enlarged uterus or uterine tumor, in which the limited field-of-view of TVUS cannot image all portions of the uterus or uterine tumor. US Pelvis Transvaginal TVUS should be combined with transabdominal US whenever possible in order to fully assess the pelvic structures. Combining the anatomic overview provided by the transabdominal approach with the greater spatial and contrast resolution of transvaginal imaging will allow for more complete assessment of the pelvis. TVUS is able to detect Abnormal Uterine Bleeding Leiomyomas and adenomyosis are other structural causes of AUB.
Abnormal Uterine Bleeding. US Duplex Doppler Pelvis Although it is rated as a separate imaging procedure per ACR methodology, this document considers Doppler imaging to be a standard component of pelvic US. Color and spectral Doppler are routinely used in pelvic US examinations to evaluate internal vascularity of pelvic findings and distinguish fluid from vascular soft-tissue. US duplex Doppler evaluation of the vascularity of the endometrium can help identify vessels within endometrial polyps or cancer, or the lack of vascularity in the normal endometrium [30]. Visualization of a vascular pedicle during transvaginal color Doppler imaging has a specificity of 62% to 98% and a negative predictive value of 50% to 94% for the detection of endometrial polyps [34-36]. Currently, investigations are ongoing to evaluate whether color Doppler patterns can differentiate endometrial polyps from endometrial cancer [4,34,37]. The addition of Doppler may improve the sensitivity, specificity, and positive predictive value of US for the diagnosis of adenomyosis [38]. To our knowledge, there is no relevant literature that has assessed vascularity of leiomyomas and leiomyosarcomas in order to differentiate these two entities. US Pelvis Transabdominal A combined transabdominal and transvaginal approach is typically used for pelvic US imaging. Transabdominal US is most helpful in the case of a significantly enlarged uterus or uterine tumor, in which the limited field-of-view of TVUS cannot image all portions of the uterus or uterine tumor. US Pelvis Transvaginal TVUS should be combined with transabdominal US whenever possible in order to fully assess the pelvic structures. Combining the anatomic overview provided by the transabdominal approach with the greater spatial and contrast resolution of transvaginal imaging will allow for more complete assessment of the pelvis. TVUS is able to detect Abnormal Uterine Bleeding Leiomyomas and adenomyosis are other structural causes of AUB.