Application value of two-dimensional transvaginal ultrasonography, three-dimensional ultrasonography volumetric imaging and three-dimensional Doppler ultrasound in the diagnosis of prolapsed submucosal myoma

ObjectiveTo evaluate the application value of two-dimensional transvaginal ultrasonography(2D-TVS), three-dimensional transvaginal ultrasonography(3D-TVS) volumetric imaging and three-dimensional Doppler ultrasound(3D-DUS) in the diagnosis and initial location of submucous myoma of prolapsed type.

MethodsFifty-seven patients with suspected prolapsed submucosal myoma deciding on surgical treatment were detected using 2D-TVS and 3D-TVS before operation. Taking the surgery results as golden standard, the diagnostic accuracy was compared between the two methods. According to the surgical results, the patients with protuberant submucosal myoma and patients with non-myomatous disease were divided into the confirmed group and suspected group, respectively. The ultrasonographic characteristics of "low echo" and "Ⅰ shaped pedicle structure" were compared between two groups.

ResultsThere were 34 cases of prolapsive submucosal myoma, 20 cases of cervical polyp, 1 case of cervical cancer, 1 case of endometrial cancer and 1 case of cervical myom according to the results of the surgery and pathology. The diagnostic sensitivity of 2D-TVS and 3D-TVS was 88.2% and 94.1%, respectively, and the difference of which was not statistically significant(P > 0.05). The specificity of 2D-TVS and 3D-TVS was 54.5% and 86.4%, respectively, and which of 3D-TVS was higher than that of 2D-TVS(P < 0.05). The percentage of consistency in 2D-TVS and 3D-TVS was 75% and 91%, respectively. In terms of the low echo, "Ⅰ shaped" pedicle structure and rich strip blood flow in 2D-TVS, and pear-shaped" mass of 3D-TVS and strip bundle blood flow of 3D-DUS, the detection rate of which in confirmed group was higher than that in suspected group(P < 0.05 to P < 0.01).

Conclusions2D-TVS and 3D-TVS can be used to diagnose the submucous myoma of prolapsed type, and the diagnostic specificity of the 3D-TVS is higher than that of the 2D-TVS. The sonographic characteristics of tumor morphology and blood flow displayed by 2D-TVS, 3D-TVS and 3D-DUS can be used as the diagnostic and differential diagnostic indicators, which can improve the diagnostic accuracy and reduce misdiagnosis and missed diagnosis.