Achados de ultrassonografia 3D com Power Doppler em pacientes com sangramento uterino pós menopausa – uma revisão sistemática de literatura com metanálise

Abstract

Introduction: Recently, 3D ultrasound findings with Power Doppler have been introduced as a diagnostic tool for Endometrial Cancer (EC). With this in mind, the main objective of this systematic review was to evaluate the findings of ultrasound power doppler - Endometrial Volume (LV), Vascular Flow Index (IFV), Vascularization Index (IV) and Flow Index (IF) - to determine whether these parameters can improve the detection of FB and estimate, from a meta-analysis, the combined mean values of these parameters for patients with benign and malignant findings. Method: We conducted a systematic review according to the preferred reporting item guidelines for systematic reviews and meta-analyzes (PRISMA) limited to the English, Portuguese and Spanish languages of studies published between January 2000 and January 2020. A combined estimate of the median The overall findings of the US with Power Doppler of patients in the benign and malignant group were calculated using a random effects model with inverse variance weighting and visualized using a Forest Plot. Results: 6 studies were included in this meta-analysis which resulted in a total of 652 women with uterine bleeding in the post-menopausal period. The combined mean endometrial volume estimate for women with benign findings was 4.51 mL (95% CI 3.10 - 5.91). The combined mean estimate for malignant findings was 8.42 mL (95% CI 6.11 - 10.74). The combined mean of VI in the benign group was 4.04 (95% CI 2.05 - 6.04) while in the malignant group it was 14.04 (95% CI 10.65 - 17.43). For the flow index, the combined mean for the benign group was 21.67 (95% CI 16.95 - 26.38). The combined mean for malignant findings was 27.84 (95% CI 22.78 - 32.90). Finally, for the VFI the combined mean for the endometriums with malignancy findings was 4.458 (95% CI 1.41 - 7.49). A statistically significant difference was found between the combined mean of the groups (p <0.001). Conclusion: To date, this is the first study that has proposed to estimate average values of 3D ultrasound findings with Power Doppler from the combination of studies described in the literature and it is also the first specific systematic review to include all data from the US 3D Power Doppler The combined average estimate of each of these parameters is extremely important for clinical practice.