Revista Sextante

Comparison of Transabdominal Versus Transvaginal Ultrasound in the Assessment and Figo Classification of Uterine Fibroids: A Comparative Cross-Sectional Study

Muhammad Ahmad Raza

Ph.D Scholar (MIT & DU), Lecturer, Department of Medical Imaging Technology, College of Allied Health Sciences, Akhtar Saeed Medical and Dental College, Lahore, Punjab, Pakistan / Visiting Lecturer, University of South Asia, Department of Allied Health Sciences, Cantt Campus, Lahore, Punjab, Pakistan

Raheel Abrar

University Institute of Radiological Sciences & MIT, The University of Lahore, Lahore, Punjab,Pakistan

Saba Waleed

Department of Radiology, Imperial College of Business Studies, Lahore, Punjab, Pakistan

Laila Ahmad

Department of Radiology, Imperial College Of Business Studies, Lahore, Punajb, Pakistan

Azka Batool

Medical Imaging Technologist, Khwaja Fareed University of Engineering & Information Technology, Rahim Yar Khan, Punjab, Pakistan

Muhammad Jamal Abdul Rahman

Imaging Technologist, Al-Nasr Lab & Diagnostic Center, Lahore, Punjab, Pakistan

Muhammad Muzamil Sajjad

10th Semester Student, University Institute of Radiological Sciences & MIT, University of Lahore, Lahore, Pakistan

Keywords: Transabdominal Ultrasound, Tranvaginal Ultrasound, FIGO Classification, Uterine Fibroids

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Abstract

Objective: To compare Transabdominal ultrasound (TAUS) and Transvaginal ultrasound (TVUS) in the detection, assessment, and FIGO classification of uterine fibroids, with particular emphasis on fibroid size, location, morphology, vascularity, and endometrial cavity distortion. Materials & Methods: A comparative cross-sectional study was conducted over six months at the University of Lahore Affiliated Ultrasound Clinic involving 120 female patients aged 20–55 years with suspected uterine fibroids. Both TAUS and TVUS were performed using 2–5 MHz and 5–9 MHz transducers, respectively. TAUS assessed uterine morphology, fibroid size, number, and location, while TVUS provided detailed evaluation of fibroid dimensions, endometrial cavity distortion, intramural involvement, and relationship with the uterine serosa. Both techniques were used to classify fibroids according to the FIGO system, with color Doppler applied when required. Results: Among 120 patients, most were aged 41–50 years (37.5%), multiparous (55.8%), and presented with menorrhagia (40%). TVUS showed significantly higher fibroid detection (96.7%) than TAUS (90.0%), particularly for small and submucosal fibroids. FIGO type 4 was the most common classification. Both techniques showed substantial agreement (κ=0.69; 73.3%). Small fibroids, submucosal location, multiple fibroids, and endometrial cavity distortion were significant predictors of classification disagreement. Overall, TVUS demonstrated better diagnostic performance for detecting and classifying small and submucosal fibroids. Conclusion: TVUS showed better detection of small and submucosal fibroids, while combining both techniques improved comprehensive assessment and FIGO classification accuracy.