The value of microvascular flow imaging and color Doppler flow imaging in the differential diagnosis of benign and malignant endometrial lesions.

AIM: To investigate the value of microvascular flow (MV-Flow) imaging and its quantitative parameter, the vascular index (VIMV), in the differential diagnosis of benign and malignant endometrial lesions, and to compare it with color Doppler flow imaging (CDFI).

MATERIALS AND

METHODS

This was a retrospective case-control study including 132 patients with endometrial lesions. Preoperative examinations with CDFI and MV-Flow were performed to assess blood flow visualization and calculate VIMV. Using postoperative histopathological results as the gold standard, receiver operating characteristic (ROC) curve analysis was employed to evaluate and compare the diagnostic performance of VIMV, MV-Flow, and CDFI.

RESULTS

MV-Flow achieved higher overall blood flow detection rates for both benign and malignant lesions (88.63%) and for malignant lesions specifically (100%) compared to CDFI (73.48% and 86.36%, respectively), with clearer visualization of microvessels. The vascular pattern of MV-Flow differed significantly between benign and malignant groups (P<.001), with the malignant group predominantly showing multiple vessels (focal origin and multifocal origin). ROC analysis revealed AUCs for differentiating benign from malignant lesions of 0.872 for VIMV, 0.846 for MV-Flow, and 0.786 for CDFI. Using a VIMV cutoff value of ≥15.6 yielded a diagnostic sensitivity of 79.55% and specificity of 77.27%. Both VIMV and MV-Flow demonstrated significantly higher diagnostic efficacy than CDFI (P=.015 and P=.026, respectively).

CONCLUSION

MV-Flow is superior to CDFI in visualizing microvessels in endometrial lesions and provides richer blood flow information. Its quantitative parameter VIMV has high diagnostic value.