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Background <p>Abnormal uterine bleeding (AUB) is a common gynaecological complaint. The present study aimed to evaluate the diagnostic accuracy of clinical examination and transvaginal sonography (TVS) with B-mode uterine artery color Doppler imaging, using histopathology as the gold standard, in women with AUB.</p> Methods <p>A cross-sectional analytical study was conducted by the Obstetrics and Gynecology department in collaboration with the Radiodiagnosis and Pathology departments over two years at a rural tertiary center in Southern India. A total of 339 women aged 20–55 years presenting with AUB were enrolled after clinical evaluation and TVS with uterine artery color Doppler imaging. Final diagnosis was confirmed through histopathological examination of endometrial biopsy/hysterectomy/myomectomy specimens. Clinical, radiological, and histopathological findings were analysed and correlated.</p> Results <p>Heavy and prolonged menstrual bleeding was the most common presenting symptom (89.1%). Clinically, AUB-E (31.6%) was the most frequent diagnosis, whereas TVS most commonly identified AUB-O (40.4%). Radiological–histopathological concordance (67.6%) was higher than clinical–histopathological concordance (43.4%). Uterine artery Doppler indices—pulsatility index (PI), resistance index (RI), and peak systolic velocity (PSV)—showed significant variation across AUB subtypes (<i>p</i> &lt; 0.001). Receiver operating characteristic analysis demonstrated excellent discriminatory ability of Doppler indices for differentiating benign from malignant lesions. TVS with B-mode color Doppler showed superior sensitivity (80.0%), specificity (99.7%), and overall diagnostic accuracy (99.41%) compared with clinical assessment alone.</p> Conclusion <p>TVS with B-mode uterine artery Doppler demonstrated good diagnostic performance in the evaluation of AUB and shows reasonable concordance with histopathological findings.</p>

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Diagnostic Accuracy of Clinical Evaluation and Transvaginal Sonography with Uterine Artery Doppler in Abnormal Uterine Bleeding: A Histopathology-Validated Prospective Cross-Sectional Study

  • 期刊论文

  • 发表日期：

    2026年6月26日

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  • Subhrajyoti Roy,
  • Naina Kumar,
  • Annapurna Srirambhatla,
  • Ashutosh Rath,
  • Mishu Mangla

摘要

Background

Abnormal uterine bleeding (AUB) is a common gynaecological complaint. The present study aimed to evaluate the diagnostic accuracy of clinical examination and transvaginal sonography (TVS) with B-mode uterine artery color Doppler imaging, using histopathology as the gold standard, in women with AUB.

Methods

A cross-sectional analytical study was conducted by the Obstetrics and Gynecology department in collaboration with the Radiodiagnosis and Pathology departments over two years at a rural tertiary center in Southern India. A total of 339 women aged 20–55 years presenting with AUB were enrolled after clinical evaluation and TVS with uterine artery color Doppler imaging. Final diagnosis was confirmed through histopathological examination of endometrial biopsy/hysterectomy/myomectomy specimens. Clinical, radiological, and histopathological findings were analysed and correlated.

Results

Heavy and prolonged menstrual bleeding was the most common presenting symptom (89.1%). Clinically, AUB-E (31.6%) was the most frequent diagnosis, whereas TVS most commonly identified AUB-O (40.4%). Radiological–histopathological concordance (67.6%) was higher than clinical–histopathological concordance (43.4%). Uterine artery Doppler indices—pulsatility index (PI), resistance index (RI), and peak systolic velocity (PSV)—showed significant variation across AUB subtypes (p < 0.001). Receiver operating characteristic analysis demonstrated excellent discriminatory ability of Doppler indices for differentiating benign from malignant lesions. TVS with B-mode color Doppler showed superior sensitivity (80.0%), specificity (99.7%), and overall diagnostic accuracy (99.41%) compared with clinical assessment alone.

Conclusion

TVS with B-mode uterine artery Doppler demonstrated good diagnostic performance in the evaluation of AUB and shows reasonable concordance with histopathological findings.