Transvaginal ultrasonography with and without saline infusion in assessment of myometrial invasion of endometrial cancer.
OBJECTIVE
The purpose of this study was to determine the diagnostic accuracy of saline infusion ultrasonography (SIUS) compared with transvaginal ultrasonography (TVUS) in the assessment of myometrial invasion of endometrial cancer.


METHODS
A total of 53 patients with endometrial cancer were examined preoperatively with TVUS and SIUS with respect to myometrial invasion. All patients were postmenopausal. Ultrasonographic findings were compared with histopathologic findings of the surgical specimens.


RESULTS
The median age of the patients +/- SD was 64 +/- 7 years (range, 51-77 years). In all patients, the procedure was well tolerated. The median thickness of malignant endometria was 17 +/- 9 mm (range, 2-51 mm). The specimens consisted of 40 endometrioid adenocarcinomas, 2 serous papillary carcinomas, 5 clear cell adenocarcinomas, 2 adenosquamous carcinomas, 3 mixed types, and 1 undifferentiated carcinoma. There were 18 grade G1, 24 G2, and 11 G3 cases. On histopathologic examination, superficial myometrial invasion (<or=50% of the myometrium) was present in 25 specimens (47.2%), and deep myometrial invasion (>50% of the myometrium) was present in 28 (52.8%). For superficial myometrial invasion, evaluation by TVUS was accurate in 19 (76.0%) of 25 cases, and evaluation by SIUS was accurate in 18 (72.0%) of 25. For deep myometrial invasion, evaluation by TVUS was accurate in 24 (85.7%) of 28 cases, and evaluation by SIUS was accurate in 27 (96.4%) of 28.


CONCLUSIONS
Transvaginal ultrasonography is a reliable method for assessing myometrial invasion of endometrial cancer. Saline infusion ultrasonography showed slightly better accuracy in the assessment of myometrial invasion than TVUS, but the differences were not statistically significant.
Takac
Iztok
I
Gynecology and Perinatology Service, Maribor Teaching Hospital, Ljubljanska 5, 2000 Maribor, Slovenia. iztok.takac@sb-mb.si
D018262:Adenocarcinoma, Clear Cell / Q000000981:diagnostic imaging / Q000473:pathology; D000282:Administration, Intravaginal; D000368:Aged; D002277:Carcinoma / Q000000981:diagnostic imaging / Q000473:pathology; D018269:Carcinoma, Endometrioid / Q000000981:diagnostic imaging / Q000473:pathology; D002294:Carcinoma, Squamous Cell / Q000000981:diagnostic imaging / Q000473:pathology; D018283:Cystadenocarcinoma, Papillary / Q000000981:diagnostic imaging / Q000473:pathology; D016889:Endometrial Neoplasms / Q000000981:diagnostic imaging* / Q000473:pathology; D004717:Endometrium / Q000000981:diagnostic imaging / Q000473:pathology; D005260:Female; D006801:Humans; D007089:Image Enhancement / Q000379:methods*; D008875:Middle Aged; D009215:Myometrium / Q000000981:diagnostic imaging* / Q000473:pathology; D009361:Neoplasm Invasiveness; D017698:Postmenopause; D011300:Preoperative Care; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D012965:Sodium Chloride / Q000008:administration & dosage; D014463:Ultrasonography
D012965:Sodium Chloride