Sonographic assessment of myometrial invasion of endometrial carcinoma

Carcinoma of the endometrium may be treated differently if deep myometrial invasion is present than if such invasion is not present. The depth of myometrial invasion of endometrial carcinoma was evaluated in 20 patients with histologically proved adenocarcinoma of the endometrium. In 14 instances US-based estimation of invasion was within 10% of the actual measurement of myometrial invasion on the gross specimen. In two patients the discrepancy between sonographic and actual measurement of myometrial invasion was between 11% and 20%; in one patient it was between 21% and 30%. In three patients a deeply invasive tumor was suspected on the basis of the US appearance but not found on pathologic examination. These tumors had a significant polypoid extension into the lumen. The continuity of the subendometrial halo was intact in 9 of 12 superficially invasive tumors. This zone was partially disrupted in four of six patients with deeply invasive tumors, totally disrupted in one, and intact in one. The results indicate that US can accurately depict the extent of myometrial invasion in most patients