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KMID : 0378019910340010051
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New Medical Journal
1991 Volume.34 No. 1 p.51 ~ p.57
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Sonographic Findings of Uterine Enlargement or Masses
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Abstract
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Ultrasonography is the first procedure in the workup of a patient with a definite or suspected uterine enlargement or mass.
In order to establish the characteristic findings and differential findings sonographically, sonographic findings of 170 cases of surgically and pathologically proven uterine enlargement of masses were reviewed retrospecitively.
Histologic diagnoses were myoma in 99, adenomyosis in 33, hydatidiform mole in 22, choriocarcinoma in 1, and missed abortion with placental hydropic degeneration in 16 patients. The results were as follow.
1. The common findings of uterine myoma were globular enlargement or bulging contour of uterus (68.7%), loss of central endometrial echoes (78.3%) and homogeneous (55.6%) or heterogeneous (44.4%) internal echoes.
2. The common findings of adenomyosis were diffuse enlargement without contour change(81.8%), homogeneous hypo-or isoechoic internal textures (96.9%), preserved central endometrial echoes (81.1%) and posterior uterine wall involvement (66.7%).
3. Adenomyosis should be considered when the uterus shows diffuse enlargement without contour change or visible nodule, homogeneous texture, and especially thickened posterior wall with anteri,)rly displaced central endometrial echoes.
4. Sonographic findings of hydatidiform mole were as follows.
a. The-size of uterus was larger (69.2%) in complete mole but smaller (87.5%) in partial mole as compared with expected gestational size.
b. The vesicular pattern was seen in all complete mole and in 87.5% of partial mole.
c. The gestational sac was seen in all cases of partial mole but not seen in complete mole.
d. The macerated fetus was seen in 25% of partial mole but never seen in complete mole.
5. The missed abortion with placedtal hydropic degeneration was indistinguished from a partial mole because of their similar sonographic appearance ; cystic changes of placenta, distorted gestational sac, and smaller uterus for dates.
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