Accuracy of Transvaginal Ultrasonographic Diagnosis of Retroflexed Uterus in Endometriosis, with Magnetic Resonance Imaging as Reference

Shigeru Matsuda, Masao Ichikawa, Hanako Kaseki, Kenichiro Watanabe, Shuichi Ono, Shigeo Akira, Toshiyuki Takeshita
Journal of Nippon Medical School = Nippon Ika Daigaku zasshi · 2022 · vol. 90(1) , pp. 26–32 · doi:10.1272/jnms.jnms.2023_90-106 · PMID:36273903 · W4307181071
article OA: diamond CC0 ⤵ 5 in-corpus citations
🔓 Open OA copy View on OpenAlex View on PubMed View at publisher
⚙ AI-generated summary by claude@2026-06, 2026-06-07 ⓘ

Transvaginal ultrasonography accurately measured uterine flexion angle, correlating strongly with MRI, but struggled to diagnose anteverted retroflexed uteruses, leading to false negatives.

One-sentence paraphrase of the abstract; not a substitute for reading it. No clinical advice. How this works

⚙ AI-generated deep summary by claude@2026-06, 2026-06-07 ⓘ

This retrospective study evaluated how accurately transvaginal ultrasonography (TVUS) measures uterine flexion/retroflexion by retrospectively assessing TVUS and magnetic resonance imaging (MRI) measurements in 123 patients who underwent endometriosis surgery between 2012 and 2017. TVUS uterine flexion angles showed a strong positive correlation with MRI reference measurements (r = 0.86). TVUS had no false-positive diagnoses but produced 28 false-negative diagnoses of retroflexion, with all false negatives occurring in patients with anteverted retroflexed uteruses, which the authors identify as a key limitation. This paper is centrally about endometriosis—specifically, assessing TVUS accuracy for diagnosing retroflexed uterus in endometriosis using MRI as a reference.

Read from the paper's body, not the abstract. Not a substitute for reading the paper. No clinical advice. How this works

Abstract

BACKGROUND: Accurate diagnosis of retroflexed uterus in daily practice is essential because this condition is related to pelvic pain and deep endometriosis. Uterine flexion can be measured by transvaginal ultrasonography (TVUS), a cost-effective primary test, but the accuracy required for diagnosing retroflexed uterus is unclear. This study assessed the accuracy of TVUS for diagnosis of retroflexed uterus in patients with endometriosis and compared it with that of magnetic resonance imaging (MRI) -the gold standard for measuring the uterine axis. METHODS: The study included 123 patients who underwent endometriosis surgery in our department between 2012 and 2017. Uterine flexion angles were measured by retrospectively examining TVUS and MRI images, and the correlation was analyzed. Analysis of anteverted and retroverted uterine subgroups identified aspects of diagnosing uterine flexion with TVUS. RESULTS: Uterine flexion angles on TVUS were strongly positively correlated (r = 0.86) with MRI results. Additionally, TVUS yielded no false-positive diagnoses and 28 false-negative diagnoses of retroflexion. All false-negative diagnoses occurred in patients with anteverted retroflexed uteruses. CONCLUSIONS: TVUS was generally accurate for measuring uterine flexion angle, as indicated by its strong correlation with MRI. Misdiagnosis of anteverted retroflexed uterus was a limitation of using TVUS for retroflexion diagnosis.

My notes (saved in your browser only)

Condition tags

endometriosis

MeSH descriptors

Endometriosis Endometriosis Endometriosis Endometriosis Endometriosis Endometriosis Endometriosis Endometriosis Endometriosis Uterine Retroversion Uterine Retroversion Uterine Retroversion Uterine Retroversion Uterine Retroversion Uterine Retroversion Female Female Female Female Female

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 (5)

Cited by (5)

Source provenance

europepmc
last seen: 2026-06-11T06:19:48.454388+00:00
openalex
last seen: 2026-06-10T17:14:06.276822+00:00
pubmed
last seen: 2026-06-01T00:34:20.622780+00:00
License: CC0 · commercial use OK