Color Doppler ultrasound to improve the diagnostic accuracy of the transvaginal ultrasound in the diagnosis of adenomyosis

Diaa Eldeen M. Abd El Aal, Mohammed K. Ali, Ali Sabra, Omar M. Shaaban
In: Evidence Based Womenʼs Health Journal · 2016 · vol. 6(3) , pp. 119–124 · doi:10.1097/01.ebx.0000488797.59001.cf · W2510608247
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Combined 2D transvaginal ultrasound and color Doppler demonstrated superior accuracy for diagnosing adenomyosis compared to 2D ultrasound alone, with no diagnostic value from uterine artery or intramyometrial Doppler studies.

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Abstract

Objectives To measure the accuracy of combined two-dimensional (2D) transvaginal ultrasound (TVS) and color Doppler in the diagnosis of adenomyosis and to assess the role of Doppler indices of the uterine artery and the intramyometrial blood vessels in the diagnosis of adenomyosis. Study design This was a cross-sectional observational study. Setting This study was carried out at the Women Health Hospital, Faculty of Medicine, Assiut University. Patients and methods One hundred women complaining of pelvic pain and/or uterine bleeding, clinically and sonographically diagnosed with adenomyosis, and scheduled for hysterectomy were approached for participation. Eighty patients were recruited and subjected to color Doppler examination in a trial to obtain a more accurate diagnosis of adenomyosis. In addition, uterine artery and intramyometrial Doppler studies (systolic/diastolic ratio, resistance, and pulsatility index) were measured before the scheduled hysterectomy to detect its role in diagnosis. The findings of 2D-TVS and color Doppler were compared with a gold standard of histopathology of the uterine specimens retrieved. Sensitivity, specificity, positive and negative predictive values, and overall accuracy were measured. Results Fifty specimens out of 80 uteri were histologically confirmed to have adenomyosis by histopathology. Sensitivity, specificity, positive predictive value, negative predictive value, and overall accuracy of the 2D-TVS in the diagnosis of adenomyosis were 76.0, 83.3, 88.4, 67.6, and 78.8%, respectively. However, for combined 2D-TVS and the color Doppler ultrasound, the values were 86.0, 86.67, 91.5, 78.8, and 86.3%, respectively. Myometrial cysts were the most commonly diagnosed (53.8%) ultrasonographic criteria. Neither uterine artery nor intramyometrial vessels systolic/diastolic ratio, resistance index, and pulsatility index showed a significant association with adenomyosis. Conclusion Combined 2D-TVS and color Doppler ultrasound is superior to 2D-TVS alone in the diagnosis of adenomyosis. Uterine artery and intramyometrial Doppler studies were of no diagnostic value in adenomyosis.

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adenomyosis

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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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