Role of Transvaginal Sonography and Magnetic Resonance Imaging in The Diagnosis of Uterine Adenomyosis

Background: Adenomyosis is a prevalent benign gynecological condition that affects premenopausal women. It is characterized by an increased endometrial proliferation and the invasion of the underlying myometrium. A primary radiologic instrument for this condition is transvaginal ultrasonography (TVUS) and magnetic resonance imaging (MRI). Aim of the work: To specify how MRI and TVUS are used to diagnose adenomyosis. Patients and methods: This prospective study was carried out on 20 female patients with bleeding, pelvic pain, or infertility during the late reproductive period in the Diagnostic Radiology Department, Al-Zahraa University Hospital. MRI studies were performed using a 1.5 tesla MR imager (Philips Achieva System) using a phased -array body coil. Results: There was a statistically significant association between the outcome of ultrasound and the outcome of MRI, with a p-value of p<0.05. ROC curve analysis proved the good evaluation power of the ultrasound compared to MRI “as a gold standard” in the diagnosis of uterine adenomyosis, with an accuracy of 66.5%, specificity of 40%, and sensitivity of 93.3%, with a kappa agreement of 0.672, which is good agreement. Conclusions: TVUS and MRI are effective imaging modalities for the diagnosis of adenomyosis, with excellent agreement between the two techniques. The high sensitivity and specificity of transvaginal ultrasound support its use as the primary imaging method for adenomyosis, with MRI providing additional information in selected cases. These findings have important implications for clinical practice, particularly in settings where MRI may not be readily available or affordable.