MRI, US or real-time virtual sonography in the evaluation of adenomyosis?

Purpose Real-time virtual sonography (RVS) allows displaying and synchronizing real-time US and multiplanar reconstruction of MRI images. The purpose of this study was to evaluate the feasibility and ability of RVS to assess adenomyosis since literature shows US itself has a reduced diagnostic accuracy compared to MRI.

This study was conducted over a 4-month period (March–June 2015). We enrolled in the study 52 women with clinical symptoms of dysmenorrhea, methrorragia and infertility. Every patient underwent an endovaginal US examination, followed by a 3T MRI exam and a RVS exam (Hitachi HI Vision Ascendus). The MRI image dataset acquired at the time of the examination was loaded into the fusion system and displayed together with the US images. Both sets of images were then manually synchronized and images were registered using multiple plane MR imaging. Radiologist was asked to report all three examinations separately.

On a total of 52 patients, on standard endovaginal US, adenomyosis was detected in 27 cases: of these, 21 presented diffuse adenomyosis, and 6 cases focal form of adenomyosis. MRI detected adenomyosis in 30 cases: 22 of these appeared as diffuse form and 8 as focal form, such as adenomyoma and adenomyotic cyst, thus resulting in 3 misdiagnosed cases on US. RVS confirmed all 22 cases of diffuse adenomyosis and all 8 cases of focal adenomyosis.

Thanks to information from both US and MRI, fusion imaging allows better identification of adenomyosis and could improve the performance of ultrasound operator thus to implement the contribution of TVUS in daily practice. Similar content being viewed by others

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We would like to thank Dr Luca Mastrogirolamo for his expertise which helped us in the successful comprehension of the RVS and its application. Author information Authors and Affiliations Corresponding author Ethics declarations Conflict of interest The remaining authors declare that they have no conflict of interest. Ethical standards All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. Funding Dr Lucia Manganaro has received a speaker honorarium from Hitachi Medical Systems S.p.A. Informed consent Informed consent was obtained from all individual participants included in the study. Rights and permissions About this article Cite this article Vinci, V., Saldari, M., Sergi, M.E. et al. MRI, US or real-time virtual sonography in the evaluation of adenomyosis?. Radiol med 122, 361–368 (2017). https://doi.org/10.1007/s11547-017-0729-7 Received: Accepted: Published: Issue date: DOI: https://doi.org/10.1007/s11547-017-0729-7