Correlation between transvaginal sonographic evaluation of adenomyosis and histopathological outcomes

M I Hossain, Morshida Begum, Mohammad Anowarul Kabir, A Mahbub, Mahmud Hasan Mostofa Kamal, Syeda Kulsum, Nasim Sultana, Zereen Sultana Deepa, Farah Nazlee
In: International Journal of Research in Medical Sciences · 2025 · vol. 13(4) , pp. 1447–1452 · doi:10.18203/2320-6012.ijrms20250965 · W4408965757
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⚙ AI-generated summary by claude@2026-06, 2026-06-07 ⓘ

This study evaluated transvaginal sonography's accuracy in diagnosing adenomyosis compared to histopathology, finding globular uterus, subendometrial striations, and myometrial cysts to be the most accurate indicators.

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

This prospective study evaluated the diagnostic accuracy of multiple transvaginal ultrasound (TVS) features for uterine adenomyosis by enrolling 140 patients scheduled for hysterectomy who underwent preoperative TVS, with sonographic findings compared against histopathology. Adenomyosis prevalence was 37.1%, and TVS for adenomyosis showed sensitivity of 80.8% and specificity of 61.4%, with PPV 55.3% and NPV 84.4%, and overall diagnostic accuracy of 68.6%. Among sonographic patterns, globular uterus, subendometrial echogenic linear striations, and myometrial cysts had the highest accuracy, while subendometrial linear striations had the highest diagnostic accuracy and were also highly specific (95.5%) with the highest PPV (80.0%), though heterogeneous myometrium was common but had poor specificity. The paper’s caveat is that specificity and predictive values were moderate overall, indicating TVS false positives/negatives relative to histopathology. This paper is centrally about endometriosis and/or adenomyosis — it specifically correlates transvaginal sonographic evaluation of adenomyosis with histopathological outcomes.

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Abstract

Background: Transvaginal sonography is a popular method to diagnose adenomyosis, leiomyoma and other pathology of uterus which ultimately lead to hysterectomy operative procedure. This prospective study was conducted in the Department of Radiology and Imaging, Bangabandhu Sheikh Mujib Medical University (BSMMU) to evaluate the accuracy of various transvaginal ultrasonographic findings (TVS) in the diagnosis of adenomyosis with correlation of histopathological results. Methods: One hundred and forty patients scheduled for hysterectomy also selected for preoperative transvaginal sonography. All sonographic findings were compared with the histopathological results. Results: The prevalence of adenomyosis was 37.1%. The sensitivity and specificity of these results were 80.8% and 61.4%. The positive (PPV) and negative (NPV) predictive values were 55.3% and 84.4%. Diagnostic accuracy by transvaginal sonography for adenomyosis was 68.6%. The highest accuracy for the diagnosis of adenomyosis was globular appearing uterus, subendometrial echogenic linear striations and myometrial cysts. In the diagnosis of adenomyosis among transvaginal ultrasound findings, the subendometrial linear striations had the highest diagnostic accuracy. Heterogeneous myometrium was the most common in patients with adenomyosis but with poor specificity. The most specific sonographic features were (95.5%) in the subendometrial linear striations which also had the highest PPV (80.0%) for the diagnosis of adenomyosis. All the results have been supported by statistical tests. Conclusions: Transvaginal ultrasound technique proved to be the very good diagnostic tools for the diagnosis of adenomyosis.

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adenomyosis

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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. [ expand to 2 hops ] — adds papers reached through this work's immediate citers/citees. Heavier; up to 60 extra dots.

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