Role of transvaginal sonography in diagnosing adenomyosis and its correlation with histopathology

Background: Adenomyosis represents a prevalent pathological condition within the field of gynecology, characterized by the aberrant proliferation of endometrial tissue within the myometrium of the uterus. Despite the diagnostic challenges associated with adenomyosis, this investigation underscores the significance of transvaginal sonography as a primary diagnostic modality within the context of the patient's gynecological assessment. Objectives: To find the role of transvaginal sonography in diagnosing adenomyosis and its correlation with histopathology. Methods: This cross-sectional study was carried out within the Department of Gynaecology at Liaquat National Hospital, Karachi. The total sample size comprised of 275 patients. Adenomyosis was operationally defined as the presence of endometrial glands and stroma that infiltrated the myometrium, accompanied by both hypertrophy and hyperplasia of the myometrial tissue. Descriptive statistical analyses were performed. Student's t-test was used to assess quantitative variables, whereas Chi-square test was utilized for qualitative variables. For ultrasound findings that correlated with ultimate histological diagnosis, sensitivity, specificity, negative predictive values, positive predictive values, and overall accuracy were meticulously calculated. Results: The mean age was 44.68±2.71 years. There were 20.4% females found with myometrial cyst, all had heterogenous myometrium, 10.5% had globular configuration, 86.9% had asymmetric antero-posterior uterine wall, 47.6% with sub-endometrial echogenic junctions and 90.2% with Identification of endo-myometrial junctions. We found 76.7% patients with adenomyosis by transvaginal sonography (TVS) and 80% by histopathology. Sensitivity, Specificity, PPV, NPV and accuracy were 95.9%, 100%, 100%, 85.90%, and 96.72% respectively. Conclusion: It can be concluded that adenomyosis may be identified with a significant degree of precision through the utilization of transvaginal ultrasound.