Abstract
Purpose: Endometrial polyps and submucosal myoma of the uterus are common masses occupying the uterine cavity. Strain elastography is an imaging modality that qualitatively determines the hardness of tissue. Since endometrial polyps and subuterine myomas have different tissue hardness, they are likely to be distinguishable on strain elastography and may be a useful test. Subjects and Methods: Patients who underwent hysteroscopic transcervical tumor resection (TCR) for an intrauterine tumor at our hospital between 2016 and 2019 were included in this study. Vaginal strain elastography was performed on the day before surgery. The ultrasonologist and obstetrician-gynecologist independently determined whether the patient had an endometrial polyp or a submucosal myoma. Based on the above test results, we compared the diagnostic accuracy of B-mode ultrasound and strain elastography, investigated the inter-examiner error of strain elastography, and examined how accurate the obstetrician-gynecologist’s judgment was in terms of the pathological diagnosis. Results and Discussion: According to the pathological diagnosis, uterine fibroids were found in five cases, endometrial polyps in 17 cases, and endometrial polyps and uterine fibroids in one case. There was no significant difference in the test accuracy between B-mode ultrasound and strain elastography. The Kappa coefficient between examiners was 0.61. The accuracy rate for pathological diagnosis was 95%. It is possible to distinguish between endometrial polyps and submucosal leiomyoma with strain elastography. Conclusion: Transvaginal elastography seems to be a promising tool that an obstetricians and gynecologists can use to make a differential diagnosis.
