| Backgroud:Postmenopausal vaginal bleeding is the most common cli nical symptoms in early endometrial cancer. Endometrial thickening in postmenopausal endometrial may be polyps,endometrial hyperplasia and tumors,thus need to seek a better method of screening for endometrial cancer, making these women far from unnecessary or diagnostic sucn as hysteroscopy Curettage and otherinvasive procedures.Objects:In this study, based on the use of two-dimensional transvagi nal ultrasound (Two-dimensional transvaginal sonography,2D-TVS),t hree-dimensional power Doppler technology (Three dimensional Color power angiography,3D-CPA) observes the following postmenopausal wo-men, those with vaginal bleeding. The pathology results are div ided into groups of endometrial cancer, endometrial benign lesions a nd normal control group.For the postmenopausal women with vaginal bleeding, endometrial volume and endometrial blood flow characterist ics,can or not add new informationfor the diagnosis of endometrial c ancer.Under the ROC curve Comparison, compare endometrial volum e and endometrial thickness's effectiveness of diagnosis of endomet rial cancer.Methods:After exclusion of pregnancy, radiotherapy, chemotherapy, endocrine, hormone therapy and other factors,140 postmenopausal wo men with vaginal bleeding was obtained in the Second Xiangya Ho spital. All subjects were confirmed by surgery or diagnostic curettag e in a week, and were divided into 33 cases of endometrial cance r, endometrial benign lesions 63 cases,36 cases in control groupby histopathology。After all subjects endometrial thickness layer were measured in th e 2D-TVS, the three-dimensional power Dopplerimaging was activat ed, then observe blood flow to the endometrial morphology of semi-qu antitative observation and analysis.Under the virtual organ computer-ai ded analysis (Virtual Organ Computer aided Analysis VOCAL) softw are endometrial volume and values of the three blood flowparameter s, such as vascular index (Vascularity index, VI), flow index(farbenid ox index, FI), vascularization-flow index (Vascular arbenidox index, VFI). Were measured. Results:The semi-quantitative analysis of the results were:endomet rial cancer group blood flow to the main level III,;benign endometri al blood flow to the main stage II, control group blood flow based on I-and II-level.The endometrial thickness under 2D-TVS and endometrial volum e under 3D-CPA in endometrial cancer group were significantly inc reased (p<0.05),when compared with other groups. The data show that the endometrial thickness as a diagnostic indicators, ROC area under the curve is 0.770, and endometrial volume ROC area under the curve is 0.826, and the difference was statistically significant (P <0.05).After selected the maximum sensitivity and specificity, the best and the largest critical value of endometrial cancer are diagnosed b est cutoff:endometrial thickness 5.5mm,85% sensitivity and specifici ty of 71%,:endometrial volume of the best value of 7.0ml,82% sen sitivity and specificity of 77%. VI in endometrial carcinoma were significantly increased compared with other groups(p<0.05). Diagnosis of endometrial cancer VI are a under the ROC curve of 0.801 to VI≥3.55% diagnosis of endo metrial cancer, sensitivity was 79% and specificity of 72%.Conclusions(1) 3D-CPA on the endometrial blood flow in thepreliminary semi-quantitative analysis can suggest endometrial cancer, the diagnosis of clinical ultrasound guidance.(2) The area under the ROC curve analysis, measurement ofendom etrial volume and endometrial thickness compared to thediagnosis of e ndometrial cancer, higher performance is better than the index of endome trial thickness.(3) Under 3D-CPA the VIVI vascular index in endometrial carcin omacompared with other groupS,Were significantly increased. To VI≥3. 55% for the diagnosis of endometrial cancer cutoff value,sensitivity a nd specificity high, soⅥmay be post-menopausal women, endometria 1 cancer, vaginal bleeding, bloodquantitative indicators.
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