Uterine sarcomas versus leiomyomas: gray-scale and Doppler sonographic findings.
OBJECTIVE
The aim of the study was to evaluate the contribution of gray-scale sonography and Doppler flow studies in differentiating between uterine sarcomas of different histologic types and leiomyomas.


METHODS
The study included 111 patients, divided retrospectively into 2 groups: 98 patients with leiomyomas and 13 with postoperative diagnosis of uterine sarcoma. This latter group was further divided into a group of 6 patients with uterine leiomyosarcoma and 7 with malignant mixed mesodermal tumor. The gray-scale sonograms and Doppler parameters in the 3 groups were compared.


RESULTS
The patients with leiomyomas were younger than those with sarcomas (52 years +/- 11 versus 65 years +/- 15, p < 0.05). No differences were noted between the 3 groups regarding gravidity, parity, symptoms upon admission, or findings during physical examination. The sonographic appearances of the leiomyomas were similar to those of the leiomyosarcomas, but in 6/7 cases, they were different from those of the malignant mixed mesodermal tumors. There was a significant difference between the mean resistance index in arterioles of the leiomyomas (0.59 +/- 0.01) and that of the malignant mixed mesodermal tumors (0.41 +/- 0.06) (P < 0.001) but not between those of the leiomyomas and the leiomyosarcomas (0.49 +/- 0.18).


CONCLUSIONS
Doppler flow studies may assist in differentiating between leiomyomas and malignant mixed mesodermal tumors but not between leiomyomas and leiomyosarcomas.
Aviram
Rami
R
Ultrasound Unit, Department of Obstetrics and Gynecology, Sapir Medical Center, Kfar Saba, 44281, Israel.
Ochshorn
Yifat
Y
Markovitch
Ofer
O
Fishman
Ami
A
Cohen
Ilan
I
Altaras
Marco M
MM
Tepper
Ron
R
D000367:Age Factors; D000368:Aged; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D007889:Leiomyoma / Q000000981:diagnostic imaging* / Q000473:pathology; D007890:Leiomyosarcoma / Q000000981:diagnostic imaging* / Q000473:pathology; D008875:Middle Aged; D012189:Retrospective Studies; D012509:Sarcoma / Q000000981:diagnostic imaging* / Q000473:pathology; D012680:Sensitivity and Specificity; D018608:Ultrasonography, Doppler; D014594:Uterine Neoplasms / Q000000981:diagnostic imaging* / Q000473:pathology