Sonography and Magnetic Resonance Imaging for the Diagnosis of Adenomyosis: Comparison with Histopathology

Asra Anjum, Salma Umbreen, Muhammad Nadeem, Fouzia Noreen, Fareena Asim, Saba Anwar
In: Journal of Islamabad Medical & Dental College · 2025 · vol. 13(4) , pp. 638–645 · doi:10.35787/jimdc.v13i4.1030 · W4406105449
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⚙ AI-generated summary by claude@2026-06, 2026-06-08 ⓘ

This study validated sonography and MRI against histopathology for adenomyosis diagnosis, finding sonography had higher sensitivity but MRI demonstrated superior specificity and accuracy.

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⚙ AI-generated deep summary by claude@2026-06, 2026-06-10 · read from full text ⓘ

This cross-sectional validation study compared transvaginal sonography and magnetic resonance imaging (MRI) against histopathology as the reference standard for diagnosing adenomyosis in surgical patients enrolled from August 2018 to August 2019. Sonographic and MRI findings were interpreted and then matched to consultant pathologist histopathology reports for each participant; the mean age was 38.3±5.5 years. Using histopathology as the gold standard, sonography showed diagnostic accuracy of 91.0% with sensitivity 88.0% and specificity 92.1%, while MRI showed 93.0% diagnostic accuracy with sensitivity 84.0% and specificity 96.0%. The paper notes that further improvements may require observing unusual and usual characteristics of adenomyosis. Relevance to endometriosis: adenomyosis is discussed as adjacent to endometriosis in the study context, using adenomyosis terminology that includes overlap concepts (e.g., “adenomyosis; endometriosis; internal adenomyosis”).

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Abstract

ABSTRACT Introduction: Modern magnetic resonance imaging (MRI) and transvaginal ultrasound techniques have significantly improved the ability to diagnose adenomyosis with a high level of accuracy. This enables healthcare professionals to administer customized treatments that target this specific disease condition. Objectives: To assess the accuracy of sonography and MRI in identifying adenomyosis, with histopathology serving as the reference standard for comparison i.e. the gold standard. Study Design: a cross-sectional validation design Setting: The Department of Diagnostic Radiology/ Pathology, POF Hospital / Wah Medical College, Wah Cantt. Duration of Study: From August, 2018, to August, 2019. Subjects and Methods: The patients who underwent surgical treatment in the relevant department were included in the study. Tissue samples obtained from these patients were subjected to histopathological analysis, which was interpreted by a consultant pathologist. The sonographic and MRI findings were subsequently compared to the histopathology report for each patient. Results: The mean age of the enrolled patients in the study was 38.3±5.5 years. Specificity, Sensitivity, negative predictive value, positive predictive value, and diagnostic accuracy of sonography and MRI was calculated by taking histopathology as gold standard and found to be 92.1%, 88.0%, 95.8%, 78.5%, and 91.0% respectively for sonography and 96.0%, 84.0%, 94.8%, 87.5%, and 93.0% respectively for MRI. Conclusion: Sensitivity of sonography remained to be high as compared to MRI in present study while specificity and accuracy of MRI remained to be high from sonography. It is necessary to observe the unusual and usual characteristics of adenomyosis for further improvements in diagnostic outcomes.
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Abstract

Introduction: Modern magnetic resonance imaging (MRI) and transvaginal ultrasound techniques have significantly improved the ability to diagnose adenomyosis with a high level of accuracy. This enables healthcare professionals to administer customized treatments that target this specific disease condition.

Objectives

To assess the accuracy of sonography and MRI in identifying adenomyosis, with histopathology serving as the reference standard for comparison i.e. the gold standard. Study Design: a cross-sectional validation design Setting: The Department of Diagnostic Radiology/ Pathology, POF Hospital / Wah Medical College, Wah Cantt. Duration of Study: From August, 2018, to August, 2019. Subjects and Methods: The patients who underwent surgical treatment in the relevant department were included in the study. Tissue samples obtained from these patients were subjected to histopathological analysis, which was interpreted by a consultant pathologist. The sonographic and MRI findings were subsequently compared to the histopathology report for each patient.

Results

The mean age of the enrolled patients in the study was 38.3±5.5 years. Specificity, Sensitivity, negative predictive value, positive predictive value, and diagnostic accuracy of sonography and MRI was calculated by taking histopathology as gold standard and found to be 92.1%, 88.0%, 95.8%, 78.5%, and 91.0% respectively for sonography and 96.0%, 84.0%, 94.8%, 87.5%, and 93.0% respectively for MRI.

Conclusion

Sensitivity of sonography remained to be high as compared to MRI in present study while specificity and accuracy of MRI remained to be high from sonography. It is necessary to observe the unusual and usual characteristics of adenomyosis for further improvements in diagnostic outcomes. Downloads Published Issue Section License This is an Open Access article distributed under the terms of the Creative Commons Attribution-Non Commercial License (http://creativecommons.org/licenses/by-nc/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

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Condition tags

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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