Transvaginal and transabdominal sonography: prospective comparison.

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Abstract
Transvaginal (TV) and transabdominal (TA) sonography were compared in a prospective study. A total of 230 examinations (126 pelvic, 104 pregnancy) were performed on 215 patients, ranging in age from 14 to 80 years. The improved anatomic detail on TV scans yielded new information in 138 (60%) examinations and better visualization of pelvic structures in 51 (22%) examinations. There was no important difference in diagnostic information provided by the two imaging modalities in 36 (16%) cases, and TV images were worse in five (2%). The clinical diagnosis was altered on the basis of TV sonographic findings in 54 (24%) cases and confirmed with certainty in 166 (72%). Diagnostic problems posed by TA scanning were not resolved by TV scanning in ten (4%) instances. Statistical analysis indicated that TV scanning was significantly better tha TA scanning in the visualization of gestational sac contents (P < .005), detection of fetal heart motion (P < .001), and evaluation of the endometrial canal in the retroverted or retroflexed uterus (P < .001). TV scanning was significantly better than TA scanning in visualization of the ovaries in patients with uterine leiomyomas (P < .005) but not significanlty better in peri- and postmenopausal patients (P > .05).