Diagnostic Accuracy of Ultrasound and MRI for Diagnosis of Adenomyosis Taking Histopathology as Gold Standard

Anwar, Javed; Tariq, Mehwish; Amin, Nabila; Gul, Bibi; Niaz, Ayesha; Nawaz, Khurram Haq

doi:10.51253/pafmj.v72isuppl-2.8064

Cited by 3 publications

(1 citation statement)

References 18 publications

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“…The overall frequency of adenomyosis in the studied population was found to be 64.3%. This finding is somewhat consistent with previous research suggesting that adenomyosis is a prevalent condition among women of reproductive age, although the reported prevalence can vary significantly across different populations 17,19 . Furthermore, our study explored the relationship between patient clinical demographics and adenomyosis detection.…”

Section: Discussionsupporting

confidence: 92%

Evaluating Adenomyosis with Transvaginal Sonography: Diagnostic Precision and Clinical Relevance

2024

PJMD

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Background: Adenomyosis is an important benign gynecological condition among females with variable signs and symptoms. Prompt detection of suspicious cases is important for the effective management of the disease. The objective of the current study was to determine the frequency of adenomyosis on transvaginal ultrasound (TVS), its diagnostic accuracy, and the identification of associated factors in women with symptoms of adenomyosis. Methods: This cross-sectional study was carried out at the radiology department of Dow University Hospital, Karachi, Pakistan from January 2022 to March 2023. All married females of reproductive age group presented with symptoms of adenomyosis for more than 7 days were included. Adenomyosis on TVS and histopathology were noted. Moreover, associated factors of adenomyosis were also studied. Results: Of 280 patients, adenomyosis on TVS was observed in 180 (64.3%) patients whereas on histopathology in 176 (62.9%) patients. Diagnostic accuracy of adenomyosis on TVS showed that sensitivity was 89.20%, specificity 77.88%, positive predicted value 87.22%, negative predicted value 81.00%, and accuracy was found to be 85.00%. A significantly higher proportion of adenomyosis was observed among women who had infertility (p<0.001), symptoms of dysmenorrhea (p <0.001), dyspareunia (p<0.002), urinary symptoms (p <0.001), and GI symptoms (p<0.001). Conclusion: TVS is a valuable imaging modality for identifying adenomyosis, especially in patients with clinical symptoms. Furthermore, there is a significant association between adenomyosis and various clinical symptoms, including infertility, dysmenorrhea, dyspareunia, urinary symptoms, and gastrointestinal symptoms.

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Section: Discussionsupporting

confidence: 92%

Evaluating Adenomyosis with Transvaginal Sonography: Diagnostic Precision and Clinical Relevance

2024

PJMD

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Transvaginal ultrasound versus magnetic resonance imaging for diagnosing adenomyosis: A systematic review and head‐to‐head meta‐analysis

Alcázar

Vara

Usandizaga

et al. 2022

Intl J Gynecology & Obste

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Background Transvaginal ultrasound (TVS) and magnetic resonance imaging (MRI) are used for the clinical diagnosis of adenomyosis. Objectives To compare the diagnostic accuracy of TVS and MRI for the diagnosis of adenomyosis. Search Strategy A search of studies was performed in five databases comparing TVS and MRI for the diagnosis of adenomyosis from January 1990 to May 2022. Selection Criteria Studies were eligible if they reported on the use of TVS and MRI in the same set of patients. The reference standard must be pathology (hysterectomy). Data Collection and Analysis The quality of studies was assessed using the QUADAS‐2 tool. Pooled sensitivity and specificity of both techniques were estimated and compared. Main Results Six studies comprising 595 women were included. The risk of bias of patient selection was high in three studies. The risk of bias for index tests and reference test was low. Pooled estimated sensitivity, specificity, positive likelihood ratio, and negative likelihood ratio for TVS were 75%, 81%, 3.9, and 0.31, respectively. These figures for MRI were 69%, 80%, 3.5, and 0.39, respectively. No statistically significant differences were found (p = 0.7509). Heterogeneity was high. Conclusions MRI and TVS have similar performances for the diagnosis of adenomyosis.

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Comparison of TVS and MRI for Evaluating Adenomyosis in the Dhaka Metropolitan Area, Bangladesh

2024

EJMHS

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Adenomyosis is a significant gynecologic cause of infertility, particularly in developing countries, where early diagnosis and accurate assessment of myometrial involvement are critical for appropriate risk categorization and surgical planning. While transvaginal ultrasound (TVS) is commonly used for pre-operative diagnosis, magnetic resonance imaging (MRI) is often considered superior for early and precise detection of adenomyosis. This cross-sectional study, conducted in the Department of Radiology and Imaging at BSMMU, Dhaka, aimed to evaluate the effectiveness of TVS and MRI in assessing myometrial invasion in adenomyosis. Both imaging techniques were performed on patients diagnosed with adenomyosis, and the results were compared with histopathology reports, which served as the gold standard. Statistical analysis was conducted using SPSS version 25.0. The study revealed that the majority of patients (56.7%) were aged 36-45 years, with a mean age of 41.15 years, and pelvic pain was the most common symptom, reported by 63.3% of patients. Adenomyosis was detected in 61.7% of patients using TVS and in 68.3% using MRI, with histopathology confirming the condition in 65% of cases. Among these, 53.8% had diffuse adenomyosis, while 46.2% had focal adenomyosis. MRI demonstrated a higher diagnostic accuracy with a sensitivity of 87.2%, specificity of 66.7%, positive predictive value (PPV) of 82.9%, and negative predictive value (NPV) of 73.7%, compared to TVS, which had a sensitivity of 71.8%, specificity of 57.1%, PPV of 75.7%, and NPV of 52.2%. These findings suggest that MRI is more reliable than TVS for detecting adenomyosis, though further studies are needed to confirm these results.

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Diagnostic Accuracy of Ultrasound and MRI for Diagnosis of Adenomyosis Taking Histopathology as Gold Standard

Cited by 3 publications

References 18 publications

Evaluating Adenomyosis with Transvaginal Sonography: Diagnostic Precision and Clinical Relevance

Evaluating Adenomyosis with Transvaginal Sonography: Diagnostic Precision and Clinical Relevance

Transvaginal ultrasound versus magnetic resonance imaging for diagnosing adenomyosis: A systematic review and head‐to‐head meta‐analysis

Comparison of TVS and MRI for Evaluating Adenomyosis in the Dhaka Metropolitan Area, Bangladesh

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