الفهرس 
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Abstract
The aim of this study to evaluate the role of power Doppler in the diagnosis of postmenopausal bleeding and compare the results with the results of hysteroscopic guided endometrial biopsy.
In our study we found that The histopathological diagnosis of the hysteroscopic guided biopsies were: atrophic endometrium in 12 cases (15%), different degrees of endometrial hyperplasia in 38 cases (47.5%), endometrial polyp in 16 cases (20%), endometrial cancer in 7cases (8.75%); proliferative endometrium in one case (1.25%), cervical polyp in 3cases (3.75%), and in 3 cases (3.75%) the hysteroscopic guided biopsies were insufficient for proper diagnoses.
The mean endometrial thickening in atrophic endometrium, endometrial hyperplasia, endometrial polyp, and endometrial carcinoma were 3 ± 1.2 mm, 8.6 ± 4.2 mm, 10.6 ± 3.9 mm, and 1.8 ± 0.6 mm. respectively.
There were a statistically significant differences in the mean endometrial thickness between women with endometrial carcinoma and women with normal endometrium 18± 0.6 mm. and 4.6±2.08 mm. respectively (p-value =0.021).
All cases diagnosed as endometrial carcinoma had endometrial thickness of ≥8 mm. measured by transvaginal ultrasonography so using the cut of value of 8mm had 100% sensitivity and with specificity, Positive predictive value, and diagnostic accuracy (80.4%, 73.7% and 75% respectively).
Office hysteroscopy has the best diagnostic performance in cases with endometrial polyp and with submucus uterine fibroid of Sensitivity, Specificity, Positive predictive value, Negative predictive value, and Diagnostic accuracy=100%. But its Diagnostic performance in endometrial carcinoma was less (sensitivity = 71.42%, specificity = 95.89%, positive predictive value = 62.5%, negative predictive value = 97.22%, diagnostic accuracy = 93.75%).
The diagnostic performance of power Doppler pattern (A) for endometrial carcinoma was: sensitivity = 85.71%, specificity = 97.26%, positive predictive value = 75.00%, negative predictive value = 98.61% and diagnostic accuracy = 96.25%.
The diagnostic performance of power Doppler pattern (B) for endometrial polyp was: sensitivity = 81.25%, specificity = 93.54%, positive predictive value = 68.42%, negative predictive value = 95.08% and diagnostic accuracy = 88.75%.
The diagnostic performance of power Doppler pattern (C) for endometrial hyperplasia was: sensitivity = 76.31%, specificity = 69.05%, positive predictive value = 69.05%, negative predictive value =76.31 % and diagnostic accuracy = 72.5%.
conclusion
Transvaginal power Doppler blood flow mapping is useful to differentiate benign from malignant endometrial pathology in women presenting with postmenopausal bleeding and thickened endometrium at baseline sonography.