The role of three-dimensional power Doppler hysterosonography (3-DPDS) in distinguishing atypical polypoid adenomyomas (APAs) from other intrauterine tumors: correlation with pathologic findings.

OBJECTIVE

This study was undertaken to describe the sonographic characteristics of atypical polypoid adenomyomas (APAs) of the uterus and to determine the value of three-dimensional power Doppler hysterosonography (3-DPDS) in distinguishing APA from other polypoid uterine tumors.

METHODS

Ninety-five women with a mean age of 37 years (range 28-45) with a suspicious polypoid uterine tumor were referred for preoperative evaluation with 3-DPDS. Sonographic criteria used for the diagnosis of APA were based on a system that consisted of morphological characteristics, histological evaluation and power Doppler imaging. Biopsy samples of the intrauterine tumors were obtained via operative hysteroscopy.

RESULTS

Fifteen lesions were histopathologically diagnosed as APAs, 25 as endometrial polyps and 55 as submucous myomas. In the present study, the sensitivity and specificity of 3-DPDSs in discriminating APA from other polypoid tumors was 82.5 and 86.7%, respectively.

CONCLUSIONS

APAs can be accurately distinguished from other polypoid tumors of the uterus with the use of 3-DPDS demonstrating the following characteristics: lobular tumor with inhomogeneous echotexture, echogenicity similar to myometrium, broad base, acoustic shadow and linear vessel arrangement.