Transvaginal Ultrasound Compared with Diffusion-Weighted Magnetic Resonance Image in Endometrial Factor Postmenopausal Bleeding

Abstract

Purpose: The purpose of this work was to conduct a comparative analysis of the diagnostic capabilities of transvaginal ultrasonography (TVUS) and diffusion-weighted magnetic resonance image (DW-MR) in distinguishing between malignant and benign lesions of the endometrium in post-menopausal women presenting with bleeding from their vaginas and endometrial thickness.Patients and Methods: This prospective cohort observational work was conducted on 30 ladies over 45 years old with postmenopausal vaginal bleeding and thickening of the endometrium more than 5mm. a comparative analysis of the diagnostic capabilities of TVUS and DW-MR imaging was done to differentiate between malignancies and benign conditions of the endometrium in postmenopausal women presenting with bleeding from their vaginas and endometrial thickness.Results: TVUS examination demonstrated a statistically significant variance in endometrial thickness, with lower measurements noticed in instances of benign conditions of the endometrium. There was a statistically substantial variance in the mean apparent diffusion coefficient (ADC) values between endometrial cancers and benign conditions of endometrium, with the earlier exhibiting reduced ADC values. The variation in ADC values between benign conditions of endometrium was statistically significant. Sensitivity of TVUS was 93.8% and specificity was 87.5 % in determining endometrial pathologies, while DW-MR had a sensitivity of (92.9%) and specificity (100.0%) in the diagnosis of endometrial pathology in post-menopausal individuals.Conclusions: TVUS and DW-MR are valuable for differentiating between malignancies and benign conditions of the endometrium. However, this work acknowledges that while both imaging modalities are effective, DW-MR offers superior specificity, potentially reducing false-positive diagnoses.