Limitations of transvaginal sonography for the diagnosis of adenomyosis, with histopathological correlation

Marc Bazot, M Bazot, E Daraï, Émile Daraï, J Rouger, Romain Detchev, R Detchev, A Cortez, S Uzan
Ultrasound in Obstetrics & Gynecology · 2002 · vol. 20(6) , pp. 605–611 · doi:10.1046/j.1469-0705.2002.00852.x · PMID:12493051 · W2001881750
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Transvaginal sonography (TVS) demonstrated high accuracy for adenomyosis diagnosis, though TVS alone was insufficient for enlarged uteri, necessitating combined TAS and TVS.

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Abstract

OBJECTIVES: To evaluate the accuracy of transabdominal sonography (TAS) and transvaginal sonography (TVS) for the diagnosis of adenomyosis, and to determine the diagnostic relevance of various sonographic criteria. SUBJECTS AND METHODS: A total of 129 women scheduled for hysterectomy were enrolled into this prospective study. Group 1 (n = 23) consisted of patients with menometrorrhagia who were free of myoma and endometrial disorders on TAS. Group 2 consisted of all the other patients (n = 106). TAS and TVS findings were compared to histopathological results. RESULTS: The prevalence of adenomyosis in Groups 1 and 2 was 91.3% and 24.5%, respectively. TAS had limited value for the diagnosis of adenomyosis in both groups. The sensitivity, specificity, and positive and negative predictive values of TVS in Groups 1 and 2 were 80.9% and 38.4%, 100% and 97.5%, 100% and 83.3%, and 40% and 82.9%, respectively. The accuracy of combined TAS and TVS in Groups 1 and 2 was 91.3% and 83%, respectively. The presence of myometrial cysts was the most specific ultrasound diagnostic criterion for adenomyosis. Hypoechoic linear myometrial striations related to the presence of myometrial hypertrophy correlated to hormonal status with a sensitivity of 66.6% and a specificity of 100% in Group 1. CONCLUSIONS: Our results show that TAS has a limited diagnostic capacity for adenomyosis but also that TVS alone was poor in patients with an enlarged uterus. In these cases a combination of TVS and TAS should be used.

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Condition tags

mesh:D004715adenomyosis

MeSH descriptors

Endometriosis Endosonography Adult Aged Endometriosis Endometriosis Endosonography Female Humans Middle Aged Prospective Studies

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.

References (21)

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