Journal of Ultrasound in Medicine, Vol 19, Issue 9 639-643, Copyright © 2000 by American Institute of Ultrasound in Medicine
High frequency transvaginal ultrasonography in preoperative assessment of myometrial invasion in endometrial cancer
D. Arko and I. Takac
Department of Gynecology and Perinatology, Maribor Teaching Hospital, Slovenia.
The aim of the study was to assess the depth of myometrial invasion by
endometrial cancer using preoperative 5-9 MHz, high frequency transvaginal
ultrasonography as compared with postoperative assessment using
histopathologic examination. The study included 120 patients with
histologically proven cancers of the endometrium. All patients underwent
transvaginal sonography before surgery. The depth of myometrial invasion
was classified as none, inner half of uterine wall, and outer half of
uterine wall. Of 106 (88.3%) patients with proven myometrial invasion, 98
cases (92.5%) were revealed by sonography. In 109 cases (90.8%) invasion
was believed to be present on transvaginal sonography. Histologically
proven invasion that correlated with sonography was shown in 88 patients
(73.3%). In 32 patients (26.7%) ultrasonography could not correctly predict
the depth of myometrial invasion. The depth of invasion was underestimated
in 10 (8.3%) cases and overestimated in 22 (18.3%) cases. Preoperative
assessment of invasion of the uterine wall by transvaginal ultrasonography
had an accuracy of 73% if correlated with the definitive histopathologic
examination. The role of high frequency transvaginal ultrasonography in
preoperative assessment of the depth of myometrial invasion in patients
with endometrial cancer is limited.
