Abstract
Objective: To evaluate the accuracy of pelvic ultrasonography, and the characteristics of women with inaccurate ultrasonographic diagnosis for uterine leiomyomas. Materials and methods: Preoperative pelvic ultrasonographic and postoperative pathologic findings of all women, who underwent hysterectomies for pelvic pain, menorrhagia and/or leiomyomas between December 1995 and July 2002, were evaluated. Three hundred thirty-three women, who had a transabdominal or transvaginal pelvic ultrasonography within 1 year prior to the hysterectomy, were included in the study. We assessed the accuracy of ultrasonography for uterine leiomyomas in this group, and defined the characteristics of women with inaccurate studies. Results: Despite its high sensitivity (95.9%), ultrasonography had only 42.5% specificity for detecting leiomyomas. Its positive predictive and the negative predictive values were 92.4% and 58.6%, respectively. Adenomyosis was found in the majority of the women with false-positive (70.8%) and false-negative (83.3%) results. In both groups, previous pelvic surgery and high body mass index (BMI) were also common. Conclusion: Adenomyosis is the most common final diagnosis in women with inaccurate ultrasound reports for uterine leiomyomas.
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Marshall LM, Spiegelman D, Barbieri RL, Goldman MB, Manson JE, Colditz GA, Willett WC, Hunter DJ (1997) Variation in the incidence of uterine leiomyoma among premenopausal women by age and race. Obstet Gynecol 90:967–973
Caoili EM, Hertzberg BS, Kliewer MA, DeLong D, Bowie JD (2000) Refractory shadowing from pelvic masses on sonography: a useful diagnostic sign for uterine leiomyomata. AJR 174:97–101
Leibman AJ, Kruse B, McSweeney MB (1988) Transvaginal sonography: comparison with transabdominal sonography in the diagnosis of pelvic masses. AJR 151:89–92
Mendelson EB, Bohm-Velez M, Joseph N, Neiman HL (1988) Gynecologic imaging: comparison of transabdominal and transvaginal sonography. Radiology 166:321–324
Fedele L, Bianchi S, Dorta M, Zanotti F, Brioschi D, Carinelli S (1992) Transvaginal ultrasonography in the differential diagnosis of adenoleiomyoma versus leiomyoma. Am J Obstet Gynecol 167:603–606
Cicinelli E, Romano F, Anastasio PS, Blasi N, Parisi C, Galantino P (1995) Transabdominal sonohysterography, transvaginal sonography, and hysteroscopy in the evaluation of submucous leiomyomata. Obstet Gynecol 85:42–47
Dueholm M, Lundorf E, Hansen ES, Ledertoug S, Olesen F (2002) Accuracy of magnetic resonance imaging and transvaginal ultrasonography in the diagnosis, mapping, and measurement of uterine leiomyomata. Am J Obstet Gynecol 186:409–415
Karasick S, Lev-Toaff AS, Toaff ME (1992) Imaging of uterine leiomyomas. AJR 158:799–805
Dudiak CM, Turner DA, Patel SK, Archie JT, Silver B, Norusis M (1988) Uterine leiomyomata in the infertility patient: preoperative localization with MR imaging versus US and hysterosalpingography. Radiology 167:627–630
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Harmanli, O.H., Bevilacqua, S.A., Dandolu, V. et al. Adenomyosis interferes with accurate ultrasonographic detection of uterine leiomyomas. Arch Gynecol Obstet 273, 146–149 (2005). https://doi.org/10.1007/s00404-005-0037-7
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DOI: https://doi.org/10.1007/s00404-005-0037-7