COMPARATIVE DIAGNOSTIC PERFORMANCE OF TRANSVAGINAL ULTRASONOGRAPHY AND MAGNETIC RESONANCE IMAGING IN ADENOMYOSIS: AN EVIDENCE-INTEGRATED REVIEW OF ACCURACY, REAL-WORLD EVIDENCE, AND CLINICAL IMPLEMENTATION

Xolboyeva Mashhura
In: 3030-3001 · 2026 · doi:10.5281/zenodo.23451212 · W7222871764
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This evidence-integrated review critically compares the diagnostic performance of transvaginal ultrasonography and magnetic resonance imaging for adenomyosis to establish a rigorous framework for evaluating accuracy in routine clinical care.

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This integrative evidence review compares the diagnostic performance of transvaginal ultrasonography and magnetic resonance imaging for adenomyosis by synthesizing meta-analyses, consensus guidelines, and clinical data. The authors establish a rigorous framework to evaluate how these imaging modalities perform in routine care, distinguishing between empirical findings and proposed analytical protocols without conducting new primary research or patient cohort analyses. Key methodological considerations include the application of the revised Morphological Uterus Sonographic Assessment criteria to standardize sonographic diagnosis alongside MRI benchmarks. This paper is centrally about adenomyosis — specifically focusing on the comparative accuracy and clinical implementation of non-invasive imaging techniques for diagnosing this heterogeneous uterine disorder.

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Abstract

Adenomyosis is a heterogeneous uterine disorder characterized by endometrial-like tissue within the myometrium. Diagnostic uncertainty has consequences for pain management, heavy menstrual bleeding, infertility counselling, and selection of uterus-sparing therapy. Objective: To critically compare transvaginal ultrasonography (TVUS) and magnetic resonance imaging (MRI), and to establish a rigorous framework for evaluating diagnostic performance in routine care. Methods: This integrative evidence review prioritizes comparative diagnostic meta-analyses, the revised Morphological Uterus Sonographic Assessment (MUSA) consensus, clinical guidance, and relevant methodological and regulatory publications. We distinguish published empirical findings from proposed analytical protocols; no original patient cohort, new meta -analysis, or causal treatment-effect analysis was performed. Results:
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COMPARATIVE DIAGNOSTIC PERFORMANCE OF TRANSVAGINAL ULTRASONOGRAPHY AND MAGNETIC RESONANCE IMAGING IN ADENOMYOSIS: AN EVIDENCE-INTEGRATED REVIEW OF ACCURACY, REAL-WORLD EVIDENCE, AND CLINICAL IMPLEMENTATION Authors/Creators Description Adenomyosis is a heterogeneous uterine disorder characterized by endometrial-like tissue within the myometrium. Diagnostic uncertainty has consequences for pain management, heavy menstrual bleeding, infertility counselling, and selection of uterus-sparing therapy. Objective: To critically compare transvaginal ultrasonography (TVUS) and magnetic resonance imaging (MRI), and to establish a rigorous framework for evaluating diagnostic performance in routine care. Methods: This integrative evidence review prioritizes comparative diagnostic meta-analyses, the revised Morphological Uterus Sonographic Assessment (MUSA) consensus, clinical guidance, and relevant methodological and regulatory publications. We distinguish published empirical findings from proposed analytical protocols; no original patient cohort, new meta -analysis, or causal treatment-effect analysis was performed. Results: Files Xolboyeva M 18-42 MPTTP.pdf Additional details References - 1. Alcázar JL, Vara J, Usandizaga C, Ajossa S, Pascual MA, Guerriero S. Transvaginal ultrasound versus magnetic resonance imaging for diagnosing adenomyosis: a systematic review and head-to-head meta-analysis. Int J Gynaecol Obstet. 2023;161(2):397-405. doi:10.1002/ijgo.14609. - 2. Harmsen MJ, Van den Bosch T, de Leeuw RA, et al. Consensus on revised definitions of Morphological Uterus Sonographic Assessment (MUSA) features of adenomyosis: results of modified Delphi procedure. Ultrasound Obstet Gynecol. 2022;60(1):118-131. doi:10.1002/uog.24786. - 3. Tellum T, Nygaard S, Lieng M. Noninvasive diagnosis of adenomyosis: a structured review and meta-analysis of diagnostic accuracy in imaging. J Minim Invasive Gynecol. 2020. PMID:31712162. https://pubmed.ncbi.nlm.nih.gov/31712162/. - 4. Diagnostic accuracy of transvaginal ultrasound and magnetic resonance imaging for adenomyosis: systematic review and meta-analysis and review of sonographic diagnostic criteria. J Ultrasound Med. 2021. PMID:33502767. https://pubmed.ncbi.nlm.nih.gov/33502767/. - 5. Harada T, Taniguchi F, Guo SW, et al. The Asian Society of Endometriosis and Adenomyosis guidelines for managing adenomyosis. Reprod Med Biol. 2023;22(1):e12535. doi:10.1002/rmb2.12535.

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