Ultrasound scan and magnetic resonance imaging for the diagnosis of adenomyosis: systematic review comparing test accuracy

Champaneria R, Rita Champaneria, Abedin P, Parveen Abedin, Jane Daniels, Moji Balogun, Balogun M, Khalid S. Khan
Acta obstetricia et gynecologica Scandinavica · 2010 · vol. 89(11) , pp. 1374–1384 · doi:10.3109/00016349.2010.512061 · PMID:20932128 · W2167843443
Systematic review / meta-analysis OA: bronze CC0 ⤵ 168 in-corpus citations
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This systematic review found that MRI (77% sensitivity, 89% specificity) and transvaginal ultrasound (72% sensitivity, 81% specificity) accurately diagnose adenomyosis, with MRI yielding more correct diagnoses.

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Abstract

BACKGROUND: Adenomyosis is a common condition that causes substantial morbidity. Until recently, the reference standard for a definitive diagnosis was histology of hysterectomy specimens. Ultrasound and magnetic resonance imaging (MRI) may allow accurate non-invasive diagnosis. OBJECTIVE: To compare the diagnostic accuracy of these techniques. DESIGN: Systematic review with meta-analysis. POPULATION: Women who had ultrasound and/or MRI, and whose results were compared with a reference standard. METHODS: Electronic searches were conducted in literature databases from database inception to 2010. The reference lists of known relevant articles were searched for further articles. Selected studies reported data on ultrasound and/or MRI with histological confirmation of diagnosis. Two reviewers independently selected articles without language restrictions, and extracted data in the form of 2 × 2 tables. We computed sensitivity and specificity for individual studies and pooled these results in a meta-analysis. We also performed meta-regression to examine how the index tests compared on diagnostic accuracy. RESULTS: Twenty-three articles (involving 2,312 women) satisfied the inclusion criteria. Transvaginal ultrasound had a pooled sensitivity of 72% (95% CI 65-79%), specificity of 81% (95% CI 77-85%), positive likelihood ratio of 3.7 (95% CI 2.1-6.4) and negative likelihood ratio of 0.3 (95% CI 0.1-0.5). MRI had a pooled sensitivity of 77% (95% CI 67-85%), specificity of 89% (95% CI 84-92%), positive likelihood ratio of 6.5 (95% CI 4.5-9.3), and negative likelihood ratio of 0.2 (95% CI 0.1-0.4). The results show that a correct diagnosis was obtained more often with MRI. CONCLUSION: Transvaginal ultrasound and MRI show high levels of accuracy for the non-invasive diagnosis of adenomyosis.

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Condition tags

endometriosisadenomyosis

MeSH descriptors

Endometriosis Endometriosis Magnetic Resonance Imaging Progesterone Congeners Endometriosis Endometriosis Endometriosis Female Female Humans Humans Levonorgestrel Levonorgestrel Levonorgestrel Magnetic Resonance Imaging Magnetic Resonance Imaging Progesterone Congeners Progesterone Congeners Ultrasonography Ultrasonography

Citation neighborhood (2-hop)

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. Outer rings show 2-hop neighbours — papers reached through the immediate citers/citees. [ collapse to 1-hop ]

References (62)

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