Comparison of transabdominal and transvaginal sonography in the evaluation of uterine mass with histopathological correlation.

A cross-sectional study was conducted to demonstrate the role of transvaginal (TVS) and transabdominal sonography (TAS) to detect clinically suspected uterine mass in 53 patients which could not be differentiated clinically. The sonographic findings were compared and correlated with the findings of histopathology. TAS and TVS revealed 20(37.7%) & 20(37.7%) had leiomyoma, 12(22.6%) & 14(26.4%) had Ca cervix, 6(11.3%) & 7(13.2%) had endometrial carcinoma, 1(1.9%) & 1(1.9%) had hydatidiform mole respectively. TAS revealed 5(9.4%) had thickened endometrium, and no detectable mass were detected in 9(17.0%) cases. TVS revealed polyp in 7(13.2%), and no detectable mass were detected in 4(7.5%) cases. Histopathologically confirmed leiomyoma were in 18(34.0%) cases, Ca cervix in 14(26.4%), endometrial carcinoma in 6(11.3%), adenomyosis in 1(1.9%), polyp in 7(13.2%), chronic cervicitis in 2(3.8%), hydatidiform mole in 1(1.9%) and no detectable mass were detected in 4(7.5%) cases. Sensitivity of TAS and TVS to diagnose uterine mass were 83.7% and 95.9%, specificity 25.0% and 50.0%, positive predictive value 93.2% and 95.9%, negative predictive value 11.1% and 50.0% and accuracy 79.2% and 92.5% respectively. Sensitivity of TAS & TVS to diagnose leiomyoma was 88.9% & 94.9%, specificity 88.6% & 91.4%, positive predictive value 80.0% & 85.0%, negative predictive value 93.9% & 97.0%, and accuracy 88.7% & 92.5% respectively. Sensitivity of TAS & TVS to diagnose Ca cervix were 57.1% & 78.6%, specificity 89.7% & 92.3%, positive predictive value 66.9% & 78.6%, negative predictive value 85.4% & 92.3%, and accuracy 81.1% & 88.7% respectively. So, uterine mass can be evaluated more accurately by TVS than TAS.