Transvaginal ultrasound versus magnetic resonance imaging for diagnosing adenomyosis: A systematic review and head-to-head meta-analysis

Juan Luis Alcázar, Julio Vara, J. Vara, Vara J, Claudia Usandizaga, Usandizaga C, Ajossa S, S. Ajossa, Silvia Ajossa, M. Pascual, S. Guerriero
International Journal of Gynecology & Obstetrics · 2022 · vol. 161(2) , pp. 397–405 · doi:10.1002/ijgo.14609 · PMID:36461921 · W4311204186
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⚙ AI-generated summary by gemini-2.5-flash-lite, 2026-07-09 ⓘ

This meta-analysis found no statistically significant difference in diagnostic accuracy between transvaginal ultrasound and magnetic resonance imaging for adenomyosis, with similar pooled sensitivities and specificities.

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⚙ AI-generated deep summary by claude@2026-07, 2026-07-09 · read from full text ⓘ

This systematic review and head-to-head meta-analysis compared the diagnostic accuracy of transvaginal ultrasound (TVS) versus magnetic resonance imaging (MRI) for adenomyosis using studies published between January 1990 and May 2022, including only those where both tests were applied to the same patient set and the reference standard was pathology from hysterectomy. Six studies with 595 women were included, with QUADAS-2 showing high risk of bias in patient selection for half the studies, while bias for index tests and the reference test was reported as low. Pooled estimates showed TVS sensitivity/specificity of 75%/81% and MRI of 69%/80%, with no statistically significant differences between modalities despite high heterogeneity. This paper is centrally about adenomyosis — it directly compares TVS and MRI diagnostic performance for adenomyosis using pathology-confirmed reference standards.

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Abstract

BACKGROUND: Transvaginal ultrasound (TVS) and magnetic resonance imaging (MRI) are used for the clinical diagnosis of adenomyosis. OBJECTIVES: To compare the diagnostic accuracy of TVS and MRI for the diagnosis of adenomyosis. SEARCH STRATEGY: A search of studies was performed in five databases comparing TVS and MRI for the diagnosis of adenomyosis from January 1990 to May 2022. SELECTION CRITERIA: Studies were eligible if they reported on the use of TVS and MRI in the same set of patients. The reference standard must be pathology (hysterectomy). DATA COLLECTION AND ANALYSIS: The quality of studies was assessed using the QUADAS-2 tool. Pooled sensitivity and specificity of both techniques were estimated and compared. MAIN RESULTS: Six studies comprising 595 women were included. The risk of bias of patient selection was high in three studies. The risk of bias for index tests and reference test was low. Pooled estimated sensitivity, specificity, positive likelihood ratio, and negative likelihood ratio for TVS were 75%, 81%, 3.9, and 0.31, respectively. These figures for MRI were 69%, 80%, 3.5, and 0.39, respectively. No statistically significant differences were found (p = 0.7509). Heterogeneity was high. CONCLUSIONS: MRI and TVS have similar performances for the diagnosis of adenomyosis.
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Abstract

Background

Transvaginal ultrasound (TVS) and magnetic resonance imaging (MRI) are used for the clinical diagnosis of adenomyosis. Objectives: To compare the diagnostic accuracy of TVS and MRI for the diagnosis of adenomyosis. Search strategy: A search of studies was performed in five databases comparing TVS and MRI for the diagnosis of adenomyosis from January 1990 to May 2022. Selection criteria: Studies were eligible if they reported on the use of TVS and MRI in the same set of patients. The reference standard must be pathology (hysterectomy). Data collection and analysis: The quality of studies was assessed using the QUADAS-2 tool. Pooled sensitivity and specificity of both techniques were estimated and compared. Main results: Six studies comprising 595 women were included. The risk of bias of patient selection was high in three studies. The risk of bias for index tests and reference test was low. Pooled estimated sensitivity, specificity, positive likelihood ratio, and negative likelihood ratio for TVS were 75%, 81%, 3.9, and 0.31, respectively. These figures for MRI were 69%, 80%, 3.5, and 0.39, respectively. No statistically significant differences were found (p = 0.7509). Heterogeneity was high. Conclusions: MRI and TVS have similar performances for the diagnosis of adenomyosis. Note This is an open access article under the terms of the Creative Commons Attribution-NonCommercial-NoDerivs License

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Condition tags

endometriosisadenomyosis

MeSH descriptors

Adenomyosis Adenomyosis Adenomyosis Adenomyosis Adenomyosis Adenomyosis Adenomyosis Adenomyosis Adenomyosis Adenomyosis Adenomyosis Adenomyosis Adenomyosis Adenomyosis Adenomyosis Adenomyosis Adenomyosis Adenomyosis Adenomyosis Adenomyosis

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.

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