General Obstetrics and Gynecology: GynecologyAccuracy of magnetic resonance imaging and transvaginal ultrasonography in the diagnosis, mapping, and measurement of uterine myomas☆
Section snippets
Patients
The study included 108 consecutive premenopausal patients who were scheduled for hysterectomy at a university hospital from September 1998 to February 2000. All patients gave their informed consent. Patients with previous transcervical endometrial resection, malignant diagnosis, and acute or subacute indication for hysterectomy were excluded. The indications for hysterectomy were abnormal uterine bleeding in 51 patients (48%), symptomatic myomas in 35 patients (33%), lower abdominal pain or
Results
For stating the presence of myomas, TVS and MRI were highly accurate, and their sensitivities and specificities for myoma detection were in line (Table I).Empty Cell Pathologic evidence (n) Diagnostic accuracy % 95% CI Myomas No myomas TVS Myomas by TVS 72 3* Sensitivity 99 92-100 Specificity 91 75-98 No myomas by TVS 1 30 Positive predictive value 96 88-99 Negative predictive value 97 82-100 MRI Myomas by MRI 72 6* Sensitivity 99
Comment
This study found that MRI and TVS were equally highly accurate in ascertaining the presence of myomas but that MRI was superior to TVS for the mapping of individual myomas. The efficacy of MRI did not depend on the uterine volume, but TVS efficacy became significantly poorer than that of MRI at volumes of >375 mL. Myoma detection failure rate rose to a significant level for both MRI and TVS with the number of myomas present, but this was particularly outspoken for TVS, except in patients with
Acknowledgements
We thank Professor Niels Jørgen Secher for his guidance, Professor Michael Vaeth for his statistical support, and Morten Pilegård for his help with the manuscript.
References (26)
- et al.
Transabdominal sonohysterography, transvaginal sonography, and hysteroscopy in the evaluation of submucous myomas
Obstet Gynecol
(1995) - et al.
Uterine ultrasonographic changes with gonadotropin-releasing hormone agonists
Am J Obstet Gynecol
(1999) - et al.
Magnetic resonance imaging of the uterus in vivo and in vitro at an ultra low magnetic field (0.02 T): assessment of its normal structure and of leiomyomas
Magn Reson Imaging
(1994) - et al.
Role of vaginal sonography and hysterosonography in the endoscopic treatment of uterine myomas
Fertil Steril
(2000) - et al.
Ultrasonography and magnetic resonance imaging of uterine fibroids
Obstet Gynecol Clin North Am
(1995) - et al.
Quantitative MRI of uterine leiomyomas during triptorelin treatment: reproducibility of volume assessment and predictability of treatment response
Magn Reson Imaging
(1996) - et al.
High-field MRI and US evaluation of the pelvis in women with leiomyomas
Magn Reson Imaging
(1990) - et al.
Magnetic resonance imaging, transvaginal sonography, hysterosonographic examination and diagnostic hysteroscopy in evaluation of the uterine cavity
Fertil Steril
(2001) - et al.
Magnetic resonance imaging and transvaginal ultrasonography for diagnosis of adenomyosis
Fertil Steril
(2001) - et al.
Transvaginal ultrasonography in the differential diagnosis of adenomyoma versus leiomyoma
Am J Obstet Gynecol
(1992)
A prospective comparison of transabdominal and transvaginal ultrasound with surgical findings in gynecologic disease
J Ultrasound Med
Transvaginal and transabdominal sonography: prospective comparison
Radiology
Transvaginal sonography: comparison with transabdominal sonography in the diagnosis of pelvic masses
AJR Am J Roentgenol
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Reprint requests: Margit Dueholm, MD, Department of Gynecology and Obstetrics, Aarhus University Hospital, DK-8000 Aarhus, Denmark.E-mail: [email protected]