Using color Doppler ultrasound to visualize endometrial vascularity in premenopausal and postmenopausal patients

We conducted this prospective study to determine whether the rate of endometrial vessel visualization, as detected by color Doppler ultrasound, is more common than previously reported and varies with the phase of menstrual cycle. Accurate determination of the range of typical endometrial vascularity may help facilitate earlier diagnosis of pathologic states. Eighty-three women who underwent transvaginal sonography were classified by menstrual state into groups based on luteal phase, follicular phase, or postmenopausal. Color Doppler ultrasound of the endometrium was performed with machine settings adjusted for detection of slow flow, and the number of blood vessels in the endometrium per slice was counted. Vessel density was quantified for each group and analyzed statistically with ANOVA and Pearsons correlation. Seventy-seven percent of the 83 women in our study population demonstrated endometrial vascularity. Vascularity in premenopausal women is greatest in the luteal phase, with 1.3 vessels/cm², which is 0.7 more vessels/cm² of endometrial section than for women in the follicular phase group. Women in the luteal phase had greater endometrial thickness than women in the follicular phase or postmenopausal group. This thickness was 2.5 mm greater in women in the luteal phase than in women in the follicular phase and 3.3 mm greater than in the postmenopausal women. It was concluded that endometrial vascularity can be detected by color Doppler ultrasound at rates higher than previously reported.