ADENOMYOMA AND LEIOMYOMA - DIFFERENTIAL-DIAGNOSIS WITH TRANSVAGINAL SONOGRAPHY

Purpose. The purpose of this study was to evaluate the capability of t ransvaginal sonography to differentiate adenomyomas from leiomyomas. M ethods. Two hundred six patients scheduled for surgery for symptomatic uterine masses underwent preoperative transvaginal sonography. Sonogr aphic findings were compared with pathologic findings. Pathologic find ings showed that 111 patients had leiomyomas, 48 had diffuse adenomyos is, 31 had adenomyomas, and 4 had leiomyosarcomas. Results. For the di agnosis of adenomyoma, transvaginal sonography demonstrated a sensitiv ity of 82.0%, specificity of 88.3%, positive predictive value of 84.6% , and negative predictive value of 87.5% compared with a sensitivity o f 95.1%, specificity of 82.0%, positive predictive value of 90.7%, and negative predictive value of 85.7% for the diagnosis of leiomyoma. Tw o sonographic characteristics, lesion margin (p = 0.0001) and lacunae (p = 0.0001), allowed the differ entiation of adenomyoma from leiomyom a. Conclusions. Transvaginal sonography is an effective procedure for the preoperative differentiation of adenomyoma from leiomyoma. If the status of the lesion's margins and the presence or absence of hypoecho ic lacunae were selected for analysis, leiomyomas could be correctly d iagnosed with transvaginal sonography in 95% of cases. (C) 1998 John W iley & Sons, Inc.