title: Transvaginal sonographic features of perineal masses in the female lower urogenital tract: a retrospective study of 71 patients.
abstract: OBJECTIVE
  To assess the transvaginal ultrasonographic features of perineal masses in the lower urogenital tract in a cohort of 71 women.
  
  
  METHODS
  Seventy-one women with perineal masses were referred consecutively for transvaginal ultrasonography. Two-dimensional (2D) ultrasound was used to scan the pelvic floor, including the urethra, vagina and rectum, and identify any possible areas of interest. A static three-dimensional (3D) sonographic reconstruction of the pelvic anatomy was created to further delineate the relation of the lesions with their neighboring structures. Ultrasound results were compared retrospectively with surgical pathology outcome when possible.
  
  
  RESULTS
  Seventy-nine cystic, cystic-solid or solid masses were detected on transvaginal 2D ultrasonography in the 71 women: in 44 patients, 47 anechoic cystic masses were identified and diagnosed as vaginal wall cysts; in 19 patients, 23 hyperechoic cystic masses were diagnosed as vaginal epidermoid cysts; in each of two patients, a hypoechoic cystic-solid mass showing blood-flow signals on color Doppler imaging was diagnosed as urogenital angiomyofibroblastoma; in each of three patients, a hypoechoic cyst was diagnosed as urethral diverticulum; and in three patients with a known history of gynecological malignancy, solid heterogeneous masses with blood flow signals on color Doppler imaging were diagnosed as metastatic cancer. In all patients, 3D ultrasonography delineated the anatomical relationship of these masses to the vagina, urethra and rectum.
  
  
  CONCLUSIONS
  Transvaginal 2D and 3D ultrasonography is an accurate, non-invasive, cost-effective diagnostic modality for the delineation of congenital, septic and neoplastic lower urogenital tract perineal masses in women.
authors.affiliation: Department of Ultrasound Medicine, Shengjing Hospital affiliated to China Medical University, Shenyang, China.
authors.forename: X
authors.initials: X
authors.lastname: Wang
authors.forename: H
authors.initials: H
authors.lastname: Yang
authors.forename: H
authors.initials: H
authors.lastname: Zhang
authors.forename: T
authors.initials: T
authors.lastname: Shi
authors.forename: W
authors.initials: W
authors.lastname: Ren
mesh_terms: D000328:Adult; D000368:Aged; D003560:Cysts / Q000000981:diagnostic imaging*; D005260:Female; D052776:Female Urogenital Diseases / Q000000981:diagnostic imaging*; D006801:Humans; D033162:Incidental Findings; D008875:Middle Aged; D010502:Perineum / Q000000981:diagnostic imaging*; D012189:Retrospective Studies; D014463:Ultrasonography; D055815:Young Adult
keywords: female lower urogenital tract; perineal mass; space-occupying lesion; three-dimensional; transvaginal ultrasonography; two-dimensional; ultrasound