DIFFERENTIATION BETWEEN ADENOMYOMA AND LEIOMYOMA WITH TRANSVAGINAL ULTRASONOGRAPHY

The clinical utility of transvaginal ultrasonography in the differenti ation of adenomyoma from leiomyoma was evaluated in 147 patients who h ad been scheduled for surgery due to symptomatic uterine masses. In al l subjects, ultrasonographic images obtained preoperatively were corp elated postoperatively with surgicopathological findings. Pathological findings showed that 110 patients proved to have fibroids, while 30 h ad adenomyomata. For the diagnosis of adenomyoma, transvaginal ultraso nography attained a sensitivity of 80%, a specificity of 94.3% a posit ive predictive value of 85.7% and a negative predictive value of 90.9% compared with a sensitivity of 94.3%, a specificity of 80%, a positiv e predictive value of 90.9% and a negative predictive value of 85.7% f or leiomyoma diagnosis. Further to assess which characteristic used in ultrasonography was useful in the differential diagnosis, five charac teristics were analyzed and compared by chi(2) test. These were positi on, number, margin and echogenicity of the uterine masses and the pres ence or absence of hypoechoic spaces (lacunae). Margin, echogenicity, mass number and lacunae were significantly different between both cond itions. A stepwise logistic regression procedure revealed that margin, lacunae and echogenicity were good parameters for differentiating ade nomyoma from leiomyoma. If we selected the features of distinct margin and absence of hypoechoic lacunae within the masses for analysis, lei omyoma could be correctly predicted in 97% of patients.