The usefulness of ultrasongraphy in endometrial carcinoma : Particularly comparing transabdominal and transvaginal ultrasonography

Between April, 1986 and March, 1991, 60 patients who underwent surgical treatment for endometrial carcinoma at the Department of Obstetrics and Gynecology, Okayama University Hospital, were preperatively examined by transvaginal ultrasonography (TV) and trans-abdominal ultrasonography (TA). The findings obtained were compared with the pathological findings to determine their usefulness in evaluating myometrial invasion and cervical invasion of endometrial carcinoma. Sensitvity of the lesion was 98.3% by TV and 80.0% by TA (p<0.01). Accuracy of the presence of myometrial invasion was 88.3% by TV and 70.0% by TA. Moreover, in evaluating the depth of myometrial invasion in three degrees (MO : Tumor limited to endometrium, M1 : Invasion to<1/2 myometrium, and M2 : Invasion >1/2 myometrium), the accuracy was 85.0% by TV and 61.7% by TA (p<0.01). In regard to the minimum width of the intact myometrium and the thickness of the high echoic area measured by each method, significant differences were obserevd between the M2-group and the other two group by the two methods. These p-values in TV were more significant than those in TA. In evaluating the presence of cervical invasion, the accuray was 95.0% by TV, while 88.3% by TA. Thus TV was found to be more useful than TA in the evaluation of both myometrial invasion and cerical invasion.