Transvaginal Color Doppler Sonographv of Uterine Smooth Muscle Tumors: Prediction of the Extent of Degenerative Change and Differentiation of Leiomyosarcoma from Myoma.

Lee,  Eun Ju; Lee,  Kang Rae; Ryu,  Hee Sug; Joo,  Hee Jae; Yoo,  Jung Hyun

Journal of Korean Society of Medical Ultrasound 1997;16(4): 347-354.

Eun Ju Lee, Kang Rae Lee, Hee Sug Ryu, Hee Jae Joo, Jung Hyun Yoo

¹Department of Diagnostic Radiology, Chonnam University Medical School, Korea.
²Department of Obstetrics and Gynecology, Chonnam University Medical School, Korea.
³Department of Pathology, Chonnam University Medical School, Korea.

Published online: January 1, 2001.

ABSTRACT

PURPOSE: To determine the role of transvaginal color Doppler sonography (CDS) in predicting the extent of degenerative change of uterine smooth muscle tumors and differentiating leiomyosarcoma from myoma. MATERIALS AND METHODS: In 63 patients with histologically confirmed smooth muscle tumor of uterus, we retrospectively reviewed the transvaginal sonographic and CDS findings of intratumor vascularity [location, peak systolic velocity(PSV) and resistive index(RI)]. These findings were correlated with the extent of degenerative chance and histologic patterns [myoma, smooth muscle tumors of uncertain malignant potential(STUMP), leiomyosarcoma]. RESULTS: The central vascularity was found less commonly in myoma with degenerative change, and the PSV and RI of central vascularity were significantly lower in severe degenerative change. But the PSV, RI of peripheral vascularity were not significantly different in the extent of degenerative change. The RI of peripheral and central vascularity were significantly lower in leiomyosarcoma than those of the myoma, but PSV of peripheral and central vascularity, presence of central vascularity were not significantly different. The PSV of central vascularity was higher in malignant tumors(leiomyosarcoma and STUMP), but the RI was not significantly different from the myoma with severe degenerative change. CONCLUSION: Transvaginal CDS may be useful for predicting the extent of degenerative change of the uterine smooth muscle tumors. CDS could differentiate leiomyosarcoma from myoma with or without degenerative change, but malignancy was not predicted based upon CDS findings alone.

Keywords: Uterus. US; Uterine neoplasm. US; Uterine neoplasm. diagnosis; Ultrasound(US). Doppler studies