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

Marc Bazot, Bazot M, M Bazot, Émile Daraï, Daraï E, E. Daraï, J. Rouger, Rouger J, R Detchev, Detchev R, Romain Detchev, A. Cortez, Cortez A, S. Uzan, Uzan S
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

endometriosisadenomyosis

MeSH descriptors

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

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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. Outer rings show 2-hop neighbours — papers reached through the immediate citers/citees. [ collapse to 1-hop ]

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