A PROSPECTIVE EVALUATION OF TRANSVAGINAL SONOGRAPHY FOR DETECTION OF OVARIAN DISEASE

OBJECTIVE. Despite the expanding role of transvaginal sonography in ro utine gynecologic examinations, as well as in screening for ovarian ca ncer, recent reports have noted problems when using the procedure for detecting ovarian masses and visualizing the ovaries in postmenopausal women. Our study was designed to assess prospectively the capability of transvaginal sonography in evaluating the ovary and detecting adnex al masses. SUBJECTS AND METHODS. Transvaginal sonography was used to e xamine 113 ovaries in 59 women within 72 hr before gynecologic surgery . Ovarian size and echo texture were assessed, and a search was made f or adnexal masses. Sonograms were interpreted without knowledge of the clinical history or results of physical examination, and the sonograp hic findings were compared with surgical and pathologic data. RESULTS. In the 22 premenopausal patients, 16 (76%) of 21 histologically norma l ovaries were identified on sonograms, but only 13 (59%) of 22 adnexa l masses. Lesions as large as 177 cm3 were not detected. In the 37 pos tmenopausal patients, 12 (20%) of 59 normal ovaries and six (54%) of 1 1 adnexal masses were identified. Five malignant masses (largest, 113 cm3) were not detected. CONCLUSION. In this selected population, our a bility to detect normal postmenopausal ovaries and ovarian masses was suboptimal in a number of cases. Practitioners should be aware of pote ntial limitations in the use of this technique alone to evaluate the o vary.