DIAGNOSTIC ACCURACY OF TRANSVAGINAL ULTRASONOGRAPHY IN DIAGNOSING ADENOMYOSIS, TAKING MAGNETIC RESONANCE IMAGING FINDINGS AS GOLD STANDARD

Zainab shehzadi, Fareeha jadoon, hafsa aquil, Anashia kayani, sana Ahmed khan, Junaid khan, raheel khan, hassan khan jadoon, Ahsen farooq

Abstract


Objectives: To determine the diagnostic accuracy of transvaginal ultrasonography in diagnosing adenomyosis, taking magnetic resonance imaging findings as gold standard.

Study design: Cross-sectional validation study.

Settings: Department of Radiology, Armed forces institute of radiology and imaging

Study duration: 1st January 2023 to 30 September 2023

Methodology: A total of 129 patients with suspected adenomyosis and the ages between 25-55 years were included. Patients who have uterine fibroids, intrauterine contraception device were excluded. Then in all patients, transvaginal sonography with 7 MHz probe was performed using standard technique in the presence of female staff. Each ultrasound findings was looked for adenomyosis (present/absent). All patients were then undergone magnetic resonance imaging which was performed on a 1.5-T system with T2-weighted spin-echo or T2-weighted turbo spin-echo (TSE) sequences. Each MRI findings was interpreted by one consultant radiologist and was looked for adenomyosis (present/absent). Ultrasonography findings were compared with MRI findings.

Results: Sensitivity, specificity, positive predictive value, negative predictive value and diagnostic accuracy of transvaginal ultrasonography in diagnosing adenomyosis, taking magnetic resonance imaging findings as gold standard was 94.12%, 89.83%, 91.43%, 92.98% and 92.13% respectively.

Conclusion: This study concluded that diagnostic accuracy of transvaginal ultrasonography in diagnosing adenomyosis is quite high, and has not only dramatically improved our ability of diagnosing adenomyosis but also helps the clinicians for proper management plans.

Keywords: adenomyosis, transvaginal ultrasound, sensitivity.


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References


Abbott JA. Adenomyosis and Abnormal Uterine Bleeding (AUB-A)-Pathogenesis, diagnosis, and management. Best Prac Res Clin Obstet Gynaecol. 2017;40:68-81.

Struble J, Reid S, Bedaiwy MA. Adenomyosis: a clinical review of a challenging gynecologic condition. J Minim Invasive Gynecol. 2016;23(2):164-85.

Vandermeulen L, Cornelis A, Kjaergaard Rasmussen C, Timmerman D, Van den Bosch T. Guiding histological assessment of uterine lesions using 3D in vitro ultrasonography and stereotaxis. Facts Views Vis Obgyn. 2017;9:77-84..

Hoyos LR, Benacerraf B, Puscheck EE. Imaging in endometriosis and adenomyosis. Clin Obstet Gynecol 2017;60:27e37.

Agostinho L, Cruz R, Osorio F, Alves J, Setubal A, Guerra A. MRI for adenomyosis: a pictorial review. Insights Imag. 2018;8(6):549-56.

Cunningham RK, Horrow MM, Smith RJ, Springer J. Adenomyosis: a sonographic diagnosis. Radiographics. 2018;38(5):1576-89.

Gupta S, Goel G, Agrawal S, Garg P, Khanuja E. Clinical and ultrasonological features of adenomyosis and its histopathological correlation. Int J Reprod Contracept Obstet Gynecol 2016;5:3283-9.

Sam M, Raubenheimer M, Manolea F, Aguilar H, Mathew RP, Patel VH, et al. Accuracy of findings in the diagnosis of uterine adenomyosis on ultrasound. Abdominal Radiol. 2020;45:842–50.

Pistofidis G, Makrakis E, Koukoura O, et al. Distinct types of uterine adenomyosis based on laparoscopic and histopathologic criteria. Clin Exp Obstet Gynecol 2014;41(2):113-8.

Alabiso G, Alio L, Arena S, et al. Adenomyosis: What the Patient Needs. J Minim Invasive Gynecol 2016;23(4):476-88.

Kepkep K, Tuncay YA, Göynümer G, et al. Transvaginal sonography in the diagnosis of adenomyosis: which findings are most accurate? Ultrasound Obstet Gynecol 2007;30(3):341-5.

Hanafi M. Ultrasound diagnosis of adenomyosis, leiomyoma, or combined with histopathological correlation. J Hum Reprod Sci 2013;6(3):189-93. doi: 10.4103/0974-1208.121421

Di Donato N, Bertoldo V, Montanari G, et al. Question mark form of uterus: a simple sonographic sign associated with the presence of adenomyosis. Ultrasound Obstet Gynecol 2015;46(1):126-7.

Exacoustos C, Brienza L, Di Giovanni A, Szabolcs B, Romanini ME, Zupi E, et al. Adenomyosis: three-dimensional sonographic findings of the junctional zone and correlation with histology. Ultrasound Obstet Gynecol 2011;37:471-9.

Andres MP, Borrelli GM, Ribeiro J, Baracat EC, Abr~ ao MS, Kho RM. Transvaginal ultrasound for the diagnosis of adenomyosis: systematic review and meta-analysis. J Minim Invasive Gynecol 2018;25:257-64.

Champaneria R, Abedin P, Daniels J, Balogun M, Khan KS. Ultrasound scan and magnetic resonance imaging for the diagnosis of adenomyosis: systematic review comparing test accuracy. Acta Obstet Gynecol Scand 2010;89:1374-84.

Sun YL, Wang CB, Lee CY, Wun TH, Lin P, Lin YH, et al. Transvaginal sonographic criteria for the diagnosis of adenomyosis based on histopathologic correlation. Taiwan J Obstet Gynecol 2010;49:40-4.

Kepkep K, Tuncay YA, Goynümer G, Tutal E. Transvaginal sonography in the diagnosis of adenomyosis: which € findings are most accurate? Ultrasound Obstet Gynecol 2007;30:341-5.

Meredith SM, Sanchez-Ramos L, Kaunitz AM. Diagnostic accuracy of transvaginal sonography for the diagnosis of adenomyosis: systematic review and metaanalysis. Am J Obstet Gynecol 2009;201:107.

Levgur M. Diagnosis of adenomyosis: a review. J Reprod Med 2007;52:177-93.


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