[Role of three-dimensional transvaginal sonography in evaluation of the depth of myometrial invasion of endometrial carcinoma].

OBJECTIVE: To investigate the value of three-dimensional transvaginal sonography (3-DTVS) in diagnosing depth of myometrial invasion (MI) and analyze factors that may influence 3-DTVS diagnosis. METHODS: Fifty-three patients with endometrial carcinoma proven by histological diagnosis postoperatively in Women's Hospital, Zhejiang University from 2002 to 2003 were included in the study. All patients underwent primary surgery and 2-DTVS and 3-DTVS examinations within 7 days before operation. The diagnosis of the depth of MI was made by multiplanar mode reconstruction and volume measurement based on 3-DTVS. Clinical-pathological parameters were simultaneously recorded. RESULTS: Eighteen patients were deep MI, 31 superficial MI and 4 no myometrial involvement. The sensitivity, specificity, positive and negative predictive values of 3-DTVS and 2-DTVS in detecting superficial MI were 92%, 100%, 100%, 67%; and 44%, 100%, 100%, 21%, respectively. The sensitivity, specificity, positive and negative predictive values of 3-DTVS and 2-DTVS in detecting deep MI were 72%, 86%, 72%, 86% and 75%, 84%, 67%, 89%, respectively. There was significant difference between 3-DTVS and 2-DTVS in detecting superficial MI (chi(2) = 13.2011, P = 0.005), but no significant difference in detecting deep MI (chi(2) = 0.0000, P > 0.05). The median tumor volume of deep and superficial MI was 1.12 cm(3) (Q(25 - 75) = 1.12 - 4.49) and 9.16 cm(3) (Q(25 - 75) = 3.35 - 23.12) respectively. There was a significant difference between the two groups (z = -3.72, P = 0.000). Among all the parameters involved in the study there was no significant factor influencing 3-DTVS diagnosis. CONCLUSIONS: Three-DTVS is superior to 2-DTVS in detecting superficial MI, but not in deep MI. The measurement of tumor volume with 3-DTVS could be used as an objective parameter for detecting deep MI.