Uterine sarcoma: a report of 10 cases studied by transvaginal color and pulsed Doppler sonography.

Objective: To evaluate the role of transvaginal color Doppler in differentiating uterine sarcoma from myoma.

Methods: A group of 2010 women were examined by transvaginal color Doppler ultrasonography 1 day before planned hysterectomy. Ten cases with uterine sarcoma were analyzed with respect to their color Doppler sonographic patterns and compared with 150 normal and 1850 myomatous uteri. Analysis of variance was used to test the significance among the subgroups.

Results: All cases of uterine sarcoma (100%) revealed abnormal tumoral blood vessels. The mean resistance index (RI) of these vessels was 0.37 +/- 0.03, ranging from 0.32 to 0.42, which is statistically significantly lower than that of the normal and myomatous (P < 0.001) uteri. There was no significant difference between RI in the right and left uterine arteries in each separate group; however, there was a decline in these values from normal, through myomatous, to sarcomatous uteri. Using a cutoff point of 0.40 for RI we were able to distinguish between benign and malignant myometrial tumors with a sensitivity of 90.91%, specificity of 99.82%, positive predictive value of 71.43%, and negative predictive value of 99.96%.

Conclusions: Color Doppler sonography has the potential to distinguish uterine sarcoma from benign uterine lesions.