Transvaginal Sonographic Evaluation of Myometrial Invasion in Endometrial Carcinoma

Background: This prospective study was conducted to evaluate the use of transvaginal ultrasound for characterizing myometrial invasion by endometrial carcinoma. Materials and Methods: Thirty-five consecutive patients with endometrial carcimoma scheduled to receive surgical intervention were recurited. All received transvaginal ultrasound examination the day befor operation. Sonographic criteria for myometrial invasion was defined as the loss of regularity at the ed\ ndometrium myometrium junction; the depth of myometrial invasion (superficial or deep ) depended on whether the ratio of endometrium thickness to anteroposterior diameter of the uterus was greater than 50%. The histopathologic examination of the surgical specimen was accomplished by a gynecologic pathologist and the extent of myometrial invasion was recorded. Results: The overall concordance between the sonographic evaluation of myometrial invasion and the final pathologic staging was 94. 3%. The sensitivity and specificity of detecting myometrial invasion by transvaginal ultrasound were 86.6% and 100%, respectively; the positive and negative predictive valuse ewee 100% and 90 .9%, respectively. Two tumors were underdiagnosed; none were overdiagnosed. Conclusions: We recommend the use of transvaginal ultrasound in the preoperative assessment of endometrial carcinoma to alert the gynecologist to the need for a thorough search for lymphatic extension during surgical intervention .#C249306