A prospective evaluation of transvaginal sonography for detection of ovarian disease.
OBJECTIVE
Despite the expanding role of transvaginal sonography in routine gynecologic examinations, as well as in screening for ovarian cancer, recent reports have noted problems when using the procedure for detecting ovarian masses and visualizing the ovaries in postmenopausal women. Our study was designed to assess prospectively the capability of transvaginal sonography in evaluating the ovary and detecting adnexal masses.


METHODS
Transvaginal sonography was used to examine 113 ovaries in 59 women within 72 hr before gynecologic surgery. Ovarian size and echo texture were assessed, and a search was made for adnexal masses. Sonograms were interpreted without knowledge of the clinical history or results of physical examination, and the sonographic findings were compared with surgical and pathologic data.


RESULTS
In the 22 premenopausal patients, 16 (76%) of 21 histologically normal ovaries were identified on sonograms, but only 13 (59%) of 22 adnexal masses. Lesions as large as 177 cm3 were not detected. In the 37 postmenopausal patients, 12 (20%) of 59 normal ovaries and six (54%) of 11 adnexal masses were identified. Five malignant masses (largest, 113 cm3) were not detected.


CONCLUSIONS
In this selected population, our ability to detect normal postmenopausal ovaries and ovarian masses was suboptimal in a number of cases. Practitioners should be aware of potential limitations in the use of this technique alone to evaluate the ovary.
Department of Radiology, DePaul Medical Center, Eastern Virginia Medical School, Norfolk 23505.
D J
DJ
DiSantis
J C
JC
Scatarige
G
G
Kemp
F T
FT
Given
J G
JG
Hsiu
M S
MS
Cramer
D000290:Adnexa Uteri / Q000000981:diagnostic imaging; D000291:Adnexal Diseases / Q000000981:diagnostic imaging; D000328:Adult; D005260:Female; D005833:Genital Neoplasms, Female / Q000000981:diagnostic imaging; D006801:Humans; D008593:Menopause; D008875:Middle Aged; D010049:Ovarian Diseases / Q000000981:diagnostic imaging*; D010051:Ovarian Neoplasms / Q000000981:diagnostic imaging; D010053:Ovary / Q000000981:diagnostic imaging; D011446:Prospective Studies; D014463:Ultrasonography