Tumor Vascular Pattern and Blood Flow Impedance in the Differential Diagnosis of Leiomyoma and Adenomyosis by Color Doppler Sonography

C.-C. Chiang, C H Chiang, M Y Chang, Ming‐Yang Chang, J J Hsu, Jenn-Jeih Hsu, T H Chiu, Tsung‐Hong Chiu, Kam-Fai Lee, K F Lee, T’sang‐T’ang Hsieh, T T Hsieh, Y K Soong, Yung‐Kuei Soong
Journal of assisted reproduction and genetics · 1999 · vol. 16(5) , pp. 268–275 · doi:10.1023/a:1020371614069 · PMID:10335475 · PMC3455709 · W1488914843
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⚙ AI-generated summary by claude@2026-06+body, 2026-06-12 ⓘ

Color Doppler sonography evaluated tumor vascular patterns and blood flow impedance to differentiate adenomyosis from leiomyoma, finding these criteria more reliable than morphology alone.

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⚙ AI-generated deep summary by claude@2026-06, 2026-06-12 · read from full text ⓘ

This paper studied how transvaginal or transabdominal color Doppler sonography could differentiate symptomatic uterine adenomyosis from leiomyoma in 78 surgical cases suspected on ultrasound to be one or the other, with no other coexisting pathologies. Using early follicular-phase imaging, the authors assessed morphology, tumor vascular pattern, and blood-flow impedance (including pulsatility index) and then compared findings against surgical pathology as the reference standard. They reported that morphologic criteria identified 79% of adenomyosis and 84% of leiomyoma, while adenomyosis more often showed randomly scattered/intratumoral vessels and higher pulsatility index values (PI > 1.17 in 82%), whereas leiomyomas more often showed peripheral outer feeding vessels and lower PI (≤ 1.17 in 84%). The reliability of vascular pattern and blood flow impedance was stated to be better than morphology alone, with the main caveat that imaging was performed specifically during the early follicular phase and used an intentionally restricted cohort without other pathology. This paper is centrally about adenomyosis—differentiating adenomyosis from leiomyoma using tumor vascular patterns and blood flow impedance on color Doppler sonography.

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Abstract

Purpose: Our objective was to evaluate the differences between leiomyoma and adenomyosis by color Doppler sonography with new criteria.

Methods

A total of 78 patients with symptomatic uterine nodularities who were sonographically suspected to have leiomyoma or adenomyosis without other coexisting pathologic conditions was enrolled in the study. All patients underwent transvaginal color Doppler sonography (7.0-MHz vaginal probe) or transabdominal color Doppler sonography (5.0 MHz) during the early follicular phase. The morphology, tumor vascular pattern, and blood flow impedance of the uterine tumors were measured. All of the patients underwent surgery and the pathologic reports were used as references.

Results

The mean age was not statistically significant in patients with adenomyosis versus leiomyoma (P > 0.05). The morphologic criteria for adenomyosis and leiomyoma by sonography detected 79% of adenomyosis and 84% of leiomyoma. Adenomyosis had 87% randomly scattered vessels or intratumoral signals and 88% of leiomyomas showed peripheral scattered vessels or outer feeding vessels. Eighty-two percent of adenomyoses had a pulsitility index (PI) of arteries within or around uterine tumors >1.17 and 84% of leiomyomas had a PI ≤ 1.17. The reliability test of tumor vascular pattern and blood flow impedance were better than that of using morphological criteria alone.

Conclusions

With the aid of color Doppler sonography, tumor vascular pattern and blood flow impedance of the arteries within or around uterine tumors could more accurately diagnose adenomyosis and leiomyoma in addition to the morphologic criteria on transvaginal sonography. Similar content being viewed by others

References

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Condition tags

endometriosisadenomyosis

MeSH descriptors

Endometriosis Leiomyoma Ultrasonography, Doppler, Color Uterine Neoplasms Adult Blood Flow Velocity Diagnosis, Differential Endometriosis Female Humans Leiomyoma Leiomyoma Middle Aged Predictive Value of Tests Sensitivity and Specificity Uterine Neoplasms Uterine Neoplasms

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