Intrauterine versus transvaginal sonography for benign and malignant disorders of the female reproductive tract.

Abstract

To determine the usefulness of high-frequency intrauterine (IUS) vs. transvaginal (TVS) sonography in the evaluation of benign and malignant uterine and tubal abnormalities. For IUS sonography, a high-frequency (10-30 MHz) microtip probe with a maximum beam penetration depth of 126 mm was inserted intracervically; radial scanning (360 degrees) was performed without cervical dilatation and without local or general anesthesia. For TVS, a 7.5-MHz probe was used. The study population comprised 48 patients. Thirty-three patients had gynecological diseases (cervical and endometrial cancer (n = 12), uterine leiomyomas (n = 10), sterility disorders (n = 11)); the remaining 15 patients served as a control group and had no gynecological diseases. IUS was accomplished in 45/48 (94%) patients. In contrast to TVS, preoperative staging by IUS-with assessment of depth of tumor invasion-concurred with the histopathological findings in all patients with cervical and endometrial cancer. The sonographic resolution of submucosal and intramural leiomyomas was superior with IUS vs. TVS. For patients with sterility disorders, intraluminal sonography of the Fallopian tubes was achieved in 64% of cases; endometrial nodules of the Fallopian tubes were depicted by intraluminal sonography (but not TVS). IUS is superior to TVS in the evaluation of uterine and tubal abnormalities.