Adenomyosis interferes with accurate ultrasonographic detection of uterine leiomyomas.
OBJECTIVE
To evaluate the accuracy of pelvic ultrasonography, and the characteristics of women with inaccurate ultrasonographic diagnosis for uterine leiomyomas.


METHODS
Preoperative pelvic ultrasonographic and postoperative pathologic findings of all women, who underwent hysterectomies for pelvic pain, menorrhagia and/or leiomyomas between December 1995 and July 2002, were evaluated. Three hundred thirty-three women, who had a transabdominal or transvaginal pelvic ultrasonography within 1 year prior to the hysterectomy, were included in the study. We assessed the accuracy of ultrasonography for uterine leiomyomas in this group, and defined the characteristics of women with inaccurate studies.


RESULTS
Despite its high sensitivity (95.9%), ultrasonography had only 42.5% specificity for detecting leiomyomas. Its positive predictive and the negative predictive values were 92.4% and 58.6%, respectively. Adenomyosis was found in the majority of the women with false-positive (70.8%) and false-negative (83.3%) results. In both groups, previous pelvic surgery and high body mass index (BMI) were also common.


CONCLUSIONS
Adenomyosis is the most common final diagnosis in women with inaccurate ultrasound reports for uterine leiomyomas.
Department of Obstetrics and Gynecology, Baystate Medical Center, 759 Chestnut Street, S-1681, Springfield, MA 01199, USA. oz.harmanli@bhs.org
Ozgur H
OH
Harmanli
Silvia A
SA
Bevilacqua
Vani
V
Dandolu
Ashwin J
AJ
Chatwani
Enrique
E
Hernandez
D000328:Adult; D000368:Aged; D004715:Endometriosis / Q000000981:diagnostic imaging* / Q000453:epidemiology; D005260:Female; D006801:Humans; D007889:Leiomyoma / Q000000981:diagnostic imaging* / Q000453:epidemiology; D008875:Middle Aged; D010414:Pennsylvania / Q000453:epidemiology; D011237:Predictive Value of Tests; D012680:Sensitivity and Specificity; D014463:Ultrasonography; D014591:Uterine Diseases / Q000000981:diagnostic imaging* / Q000453:epidemiology; D014594:Uterine Neoplasms / Q000000981:diagnostic imaging / Q000453:epidemiology