This Article Full Text Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Services Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Becker, E. Articles by Kurtz, A. B. Search for Related Content PubMed PubMed Citation Articles by Becker, E., Jr Articles by Kurtz, A. B.

The Added Value of Transvaginal Sonohysterography Over Transvaginal Sonography Alone in Women With Known or Suspected Leiomyoma

Department of Radiology, Division of Ultrasound, Thomas Jefferson University Hospital, Philadelphia, Pennsylvania (E.B., A.S.L.-T., E.P.K., E.J.H., A.B.K.); and Postgraduate Program in Medicine, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil (M.I.E.)

Anna S. Lev-Toaff, MD, Department of Radiology, Thomas Jefferson University Hospital, 111 S 11th St, Gibbon Building, Suite 3390, Philadelphia, PA 19107.

Objective. To assess whether sonohysterography provides added diagnostic value over transvaginal sonography in patients with suspected or known myomas by comparing diagnostic confidence, interobserver agreement, accuracy, and change in diagnoses when 2 independent observers interpreted transvaginal sonography alone and later interpreted transvaginal sonography and sonohysterography together. Methods. Hard copy images from 72 women were interpreted independently by 2 sonologists on separate occasions, rating parameters (abnormal uterus, myoma in any location, submucous myoma, classification of location of a submucous myoma with respect to the uterine cavity, myoma remote from the cavity, adenomyosis, and focal and diffuse endometrial lesions) on a scale of 1 to 5 (1 indicated definitely no; 2, probably no; 3, uncertain; 4, probably yes; and 5, definitely yes). Correlation was made with clinical and imaging follow-up, surgery, and pathologic examination. Results. The added information provided by sonohysterography resulted in improved diagnostic confidence for most parameters. Interobserver agreement was markedly improved for the diagnosis and location of submucous myomas and focal endometrial lesions. Sensitivity values for submucous myomas and focal endometrial lesions were 100% and 90% for transvaginal sonography and sonohysterography together and 100% and 70% for transvaginal sonography alone. Conclusions. We found that sonohysterography does provide additional information over transvaginal sonography alone and is an important adjunct to transvaginal sonography in symptomatic women with known or suspected myomas, particularly before surgical or medical therapy.

Key Words: abnormal uterine bleeding • fibroid • sonohysterography • submucous leiomyoma • transvaginal sonography • uterus

Abbreviations: SHG, sonohysterography • TVS, transvaginal sonography

This article has been cited by other articles:

				E. Somigliana, P. Vercellini, R. Daguati, R. Pasin, O. De Giorgi, and P.G. Crosignani Fibroids and female reproduction: a critical analysis of the evidence Hum. Reprod. Update, September 1, 2007; 13(5): 465 - 476. [Abstract] [Full Text] [PDF]

				S. Ghai, D. K. Rajan, M. S. Benjamin, M. R. Asch, and S. Ghai Uterine Artery Embolization for Leiomyomas: Pre- and Postprocedural Evaluation with US RadioGraphics, September 1, 2005; 25(5): 1159 - 1172. [Abstract] [Full Text] [PDF]

				I. Imaoka, A. Wada, M. Matsuo, M. Yoshida, H. Kitagaki, and K. Sugimura MR Imaging of Disorders Associated with Female Infertility: Use in Diagnosis, Treatment, and Management RadioGraphics, November 1, 2003; 23(6): 1401 - 1421. [Abstract] [Full Text] [PDF]

				G. Wegienka, D. D. Baird, I. Hertz-Picciotto, S. D. Harlow, J. F. Steege, M. C. Hill, J. M. Schectman, and K. E. Hartmann Self-Reported Heavy Bleeding Associated With Uterine Leiomyomata Obstet. Gynecol., March 1, 2003; 101(3): 431 - 437. [Abstract] [Full Text] [PDF]

				F. Nawroth and D. Foth IVF outcome and intramural fibroids not compressing the uterine cavity Hum. Reprod., September 1, 2002; 17(9): 2485 - 2485. [Full Text] [PDF]

				J.H. Check IVF outcome and intramural fibroids not compressing the uterine cavity Hum. Reprod., September 1, 2002; 17(9): 2485 - 2486. [Full Text] [PDF]