title: Tumor vascular pattern and blood flow impedance in the differential diagnosis of leiomyoma and adenomyosis by color Doppler sonography.
abstract: OBJECTIVE
  Our objective was to evaluate the differences between leiomyoma and adenomyosis by color Doppler sonography with new criteria.
  
  
  METHODS
  A total of 78 patients with symptomatic uterine nodularities who were sonographically suspected to have leiomyoma or adenomyosis without other coexisting pathologic conditions was enrolled in the study. All patients underwent transvaginal color Doppler sonography (7.0-MHz vaginal probe) or transabdominal color Doppler sonography (5.0 MHz) during the early follicular phase. The morphology, tumor vascular pattern, and blood flow impedance of the uterine tumors were measured. All of the patients underwent surgery and the pathologic reports were used as references.
  
  
  RESULTS
  The mean age was not statistically significant in patients with adenomyosis versus leiomyoma (P > 0.05). The morphologic criteria for adenomyosis and leiomyoma by sonography detected 79% of adenomyosis and 84% of leiomyoma. Adenomyosis had 87% randomly scattered vessels or intratumoral signals and 88% of leiomyomas showed peripheral scattered vessels or outer feeding vessels. Eighty-two percent of adenomyosis had a pulsitility index (PI) of arteries within or around uterine tumors > 1.17 and 84% of leiomyomas had a PI < or = 1.17. The reliability test of tumor vascular pattern and blood flow impedance were better than that of using morphological criteria alone.
  
  
  CONCLUSIONS
  With the aid of color Doppler sonography, tumor vascular pattern and blood flow impedance of the arteries within or around uterine tumors could more accurately diagnose adenomyosis and leiomyoma in addition to the morphologic criteria on transvaginal sonography.
authors.affiliation: Department of Obstetrics and Gynecology, Chang Gung Memorial Hospital 199, Taipei, Taiwan, Republic of China.
authors.forename: C H
authors.initials: CH
authors.lastname: Chiang
authors.forename: M Y
authors.initials: MY
authors.lastname: Chang
authors.forename: J J
authors.initials: JJ
authors.lastname: Hsu
authors.forename: T H
authors.initials: TH
authors.lastname: Chiu
authors.forename: K F
authors.initials: KF
authors.lastname: Lee
authors.forename: T T
authors.initials: TT
authors.lastname: Hsieh
authors.forename: Y K
authors.initials: YK
authors.lastname: Soong
mesh_terms: D000328:Adult; D001783:Blood Flow Velocity; D003937:Diagnosis, Differential; D004715:Endometriosis / Q000000981:diagnostic imaging*; D005260:Female; D006801:Humans; D007889:Leiomyoma / Q000098:blood supply / Q000000981:diagnostic imaging*; D008875:Middle Aged; D011237:Predictive Value of Tests; D012680:Sensitivity and Specificity; D018615:Ultrasonography, Doppler, Color; D014594:Uterine Neoplasms / Q000098:blood supply / Q000000981:diagnostic imaging*