Transvaginal ultrasonography in the differential diagnosis of adenomyoma versus leiomyoma

OBJECTIVE: We evaluated the reliability of transvaginal ultrasonography in the differential diagnosis of adenomyoma versus leiomyoma. STUDY DESIGN: Preoperative transvaginal ultrasonographic results were compared with postoperative pathologic findings in 405 women who underwent surgery for symptomatic uterine nodularity. RESULTS: For adenomyoma diagnosis, transvaginal ultrasonography demonstrated a sensitivity of 87%, a specificity of 98%, a positive predictive value of 74.1%, and a negative predictive value of 98.6%, compared with a sensitivity of 96.1%, a specificity of 83.3%, a positive predictive value of 98.4%, and negative predictive value of 35.7% for leiomyoma diagnosis. CONCLUSION: Transvaginal ultrasonography is an effective, noninvasive, and relatively inexpensive procedure for the preoperative differential diagnosis of adenomyoma versus leiomyoma.