Diagnostic Accuracy of Ultrasound and MRI for Diagnosis of Adenomyosis Taking Histopathology as Gold Standard

Javed Anwar, Mehwish Tariq, Nabila Amin, Bibi Gul, Abrar Niaz, Khurram Haq Nawaz
In: Pakistan Armed Forces Medical Journal · 2022 · vol. 72(SUPPL-2) , pp. S346–49 · doi:10.51253/pafmj.v72isuppl-2.8064 · W4312867903
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⚙ AI-generated summary by gemini-2.5-flash-lite, 2026-06-08 ⓘ

This study compared the diagnostic accuracy of MRI and transvaginal ultrasound against histopathology for detecting adenomyosis in 162 patients.

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⚙ AI-generated deep summary by claude@2026-06, 2026-06-13 · read from full text ⓘ

This cross-sectional study evaluated the diagnostic accuracy of MRI and transvaginal ultrasound for adenomyosis, using histopathology from hysterectomy biopsy specimens as the gold standard in 162 patients from radiology and gynecology departments in Quetta, Pakistan (Aug 2019–Aug 2021). All participants underwent MRI and transvaginal ultrasound, and results were compared with histopathology findings, including diffuse versus focal adenomyosis subtypes. MRI detected adenomyosis in 69.1% of patients and showed higher sensitivity (86.7%) but lower specificity (36.9%) than transvaginal ultrasound, which detected 59.9% and had sensitivity 65.7% with specificity 50.9%. The paper’s primary limitation is that accuracy estimates are tied to a hysterectomy population where all participants ultimately had surgery with histological confirmation. This paper is centrally about adenomyosis — it directly compares MRI and transvaginal ultrasound diagnostic performance against histopathology.

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Abstract

Objective: To determine the diagnostic accuracy of Magnetic Resonance Imaging (MRI) and ultrasonography to detect adenomyosis, keeping histopathology as the gold standard. Study Design: Cross-sectional study. Place and Duration of Study: Radiology and Gynecology departments of the Combined Military Hospital, Quetta Pakistan, from Aug 2019 to Aug 2021. Methodology: One hundred sixty-two patients were enrolled in this study after taking written and informed consent. After taking history, all patients were assessed by Magnetic resonance imaging and transvaginal ultrasonography. The magnetic resonance imaging and transvaginal ultrasound findings were noted on a predesigned proforma. All the patients underwent a hysterectomy, and a Biopsy specimen was sent for histological confirmation of adenomyosis. The accuracy of diagnosis was assessed in both initial modalities. Results: A total of 162 patients were enrolled in the study. The mean age of the females and junctional zone diameter (JZmax) in mm on MRI was 38.56 years and 12.54.9 mm. In terms of parity, 32 (19.8%) females were nulliparous, 68 (42%) females had low multi-parity, and 62 (38.2%) females had high multi-parity. On magnetic resonance imaging, adenomyosis was present in 112 (69.1%) females. On transvaginal ultrasound, it was present in 97 (59.9%) females, and on histopathology, it was present in 105 (64.8%) females, out of which 36 (34%) had diffuse adenomyosis and 32 (30.8%) had focal adenomyosis. The sensitivity, specificity, positive predictive value, negative predictive value and diagnostic accuracy of Magnetic resonance imaging was 86.7%, 36.9%, 81.3%, 71.8% and 78.4% respectively and of transvaginal ultrasound it was 65.7%, 50.9%,.............
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Objective

To determine the diagnostic accuracy of Magnetic Resonance Imaging (MRI) and ultrasonography to detect adenomyosis, keeping histopathology as the gold standard. Study Design: Cross-sectional study. Place and Duration of Study: Radiology and Gynecology departments of the Combined Military Hospital, Quetta Pakistan, from Aug 2019 to Aug 2021. Methodology: One hundred sixty-two patients were enrolled in this study after taking written and informed consent. After taking history, all patients were assessed by Magnetic resonance imaging and transvaginal ultrasonography. The magnetic resonance imaging and transvaginal ultrasound findings were noted on a predesigned proforma. All the patients underwent a hysterectomy, and a Biopsy specimen was sent for histological confirmation of adenomyosis. The accuracy of diagnosis was assessed in both initial modalities.

Results

A total of 162 patients were enrolled in the study. The mean age of the females and junctional zone diameter (JZmax) in mm on MRI was 38.56 years and 12.54.9 mm. In terms of parity, 32 (19.8%) females were nulliparous, 68 (42%) females had low multi-parity, and 62 (38.2%) females had high multi-parity. On magnetic resonance imaging, adenomyosis was present in 112 (69.1%) females. On transvaginal ultrasound, it was present in 97 (59.9%) females, and on histopathology, it was present in 105 (64.8%) females, out of which 36 (34%) had diffuse adenomyosis and 32 (30.8%) had focal adenomyosis. The sensitivity, specificity, positive predictive value, negative predictive value and diagnostic accuracy of Magnetic resonance imaging was 86.7%, 36.9%, 81.3%, 71.8% and 78.4% respectively and of transvaginal ultrasound it was 65.7%, 50.9%,.............

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adenomyosis

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