Evaluation of hysterography in the diagnosis of choriocarcinoma and invasive mole

From 1963 through 1985, 181 hysterography were performed for 101 patients. The diagnostic accuracy of hysterography was 92.3%. There were no false positive findings, though a negative result may be obtained in patients whose intramural lesion does not communicate with the uterine cavity, as proved by operative findings. Three types of abnormalities were observed on the hysterogram: (1) filling defect, (2) intramural invasion of the uterine wall by the contrast medium and (3) extravasation of the contrast medium into the pelvic veins. The filling defect was usually observed in patients with (1) residual molar tissue in the uterine cavity, (2) intramural lesion and (3) intrauterine adhesions. The above three conditions can be differentiated by the characteristic shape of the filling defect. If it is used in combination with either or both of the other two procedures, ie., B-ultrasound and pelvic arteriography the accuracy of diagnosis will be further improved.