Transvaginal ultrasound for diagnosis of adenomyosis: a review

Margit Dueholm
Best practice & research. Clinical obstetrics & gynaecology · 2006 · vol. 20(4) , pp. 569–582 · doi:10.1016/j.bpobgyn.2006.01.005 · PMID:16545618 · W2022269531
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This review examines the effectiveness of transvaginal ultrasound in diagnosing adenomyosis.

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Abstract

The objective of this chapter is to relate the image findings of transvaginal ultrasound (TVS) to structural changes of adenomyosis; in order to clarify the present clinical diagnostic approach in the diagnosis of adenomyosis, the performance of TVS is evaluated in comparison to other diagnostic modalities. A Medline search of papers in English on the use of TVS and needle biopsy for the diagnosis of adenomyosis was carried out. It was found that TVS is highly observer-dependent, but in the hands of experienced investigators it has an adequate diagnostic accuracy in clinically suspected cases. The diagnostic accuracy of TVS is at an intermediate level but is in line with that of magnetic resonance imaging (MRI) in unselected patients without myomas undergoing surgery. TVS is a sufficiently accurate tool for diagnosis of adenomyosis in clinically suspected cases, but not in unselected premenopausal women with myomas. Resectoscopic hysteroscopic biopsy has not been sufficiently evaluated but could be a useful diagnostic tool, whereas needle biopsy is not. In conclusion, in clinically suspected adenomyosis cases TVS should be favoured as the primary diagnostic tool. Substantial experience and specific training is required for TVS to be a useful diagnostic tool in adenomyosis. MRI may be considered when TVS is inconclusive. Clinicians should above all be observant of image findings of adenomyosis in patients with no wish to preserve fertility.

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Condition tags

endometriosisadenomyosis

MeSH descriptors

Endometriosis Uterine Diseases Biopsy, Needle Endometriosis Endometriosis Endometriosis Endometrium Endometrium Endometrium Female Humans Hysteroscopy Magnetic Resonance Imaging Myoma Myoma Myometrium Myometrium Observer Variation Postmenopause Premenopause

Citation neighborhood

Papers in the corpus that this work cites (lower rings, blue) and that cite this one (upper rings, green). Dot size scales with the paper's in-corpus citation count — bigger dot = more influential within the endo/adeno field. Click a dot to open that paper. [ expand to 2 hops ] — adds papers reached through this work's immediate citers/citees. Heavier; up to 60 extra dots.

References (87)

Cited by (50)

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