Citation Information :
Rohini A, Nambiar J, Hebbar S. Diagnostic Accuracy of Ultrasound in the Diagnosis of Adenomyosis. J South Asian Feder Obs Gynae 2024; 16 (6):641-643.
Aim and background: There is no reliable method to diagnose adenomyosis preoperatively. Recently, ultrasound has been suggested as a method to diagnose adenomyosis. The purpose of this study was to find out the accuracy of ultrasound in the diagnosis of adenomyosis. The objective of the study was to find the diagnostic accuracy of various features mentioned in morphological uterus sonographic assessment (MUSA) criteria by ultrasonography.
Materials and methods: Patients undergoing hysterectomy for abnormal uterine bleeding over 12 months underwent the study. A transvaginal ultrasound was done preoperatively to diagnose adenomyosis using MUSA criteria. Postoperatively, histopathology was done to diagnose adenomyosis. All parameters mentioned in the MUSA criteria were analyzed to find the sensitivity and specificity of MUSA criteria in diagnosing adenomyosis.
Results: Among the MUSA criteria, the highest sensitivity was for sunray appearance (80.85%) and asymmetrical thickening of the myometrium (80.85%). The highest specificity was for subendothelial lines (96.55%), translesional vascularity (93.10%), and hyperechoic islands (93.10%).
Conclusion: Among the MUSA criteria, sunray appearance and asymmetrical thickening of myometrium are very sensitive markers of adenomyosis.
Clinical significance: The MUSA criteria are a good marker for diagnosing adenomyosis preoperatively.
Aloudek C, Norris HJ. Mesenchymal tumors of the uterus. In: RJ Kurman, (Ed). Blaunstein's Pathology of the Female Genital Tract, New York: Springer-Verlag; 2002. pp. 487–527.
Puente JM, Fabris A, Patel J, et al. Adenomyosis in infertile women: Prevalence and the role of 3D ultrasound as a marker of severity of the disease. Reprod Biol Endocrinol 2016;14(1):60. DOI: 10.1186/s12958-016-0185-6.a.
Bergholt T, Eriksen L, Berendt N, et al. Prevalence and risk factors of Adenomyosis at Hysterectomy. Hum Reprod 2001;16(11):2418–2421. DOI: 10.1093/humrep/16.11.2418.
Fedele L, Bianchi S, Dorta M, et al. Transvaginal ultrasonography in the diagnosis of diffuse Adenomyosis. Fertil Steril 1992;58(1):94–97. PMID: 1624029.
Reinhold C, McCarthy S, Bret PM, et al. Diffuse Adenomyosis: Comparison of endovaginal US and MR imaging with histopathologic correlation. Radiology 1996;199(1):151–158. DOI: 10.1148/radiology. 199.1.8633139.
Van den Bosch T, de Bruijn AM, de Leeuw RA, et al. Sonographic classification and reporting system for diagnosing Aadenomyosis. Ultrasound Obstet Gynecol 2019;53(5):576–582. DOI: 10.1002/uog.19096.
Hanafi M. Ultrasound diagnosis of adenomyosis, leiomyoma, orcombined with histopathological correlation. J Hum Reprod Sci 2013;6(3):189–193. DOI: 10.4103/0974-1208.121421.
Tellum T, Nygaard S, Lieng M. Noninvasive diagnosis of adenomyosis: A structured review and meta–analysis of diagnostic accuracy in imaging. J Minim Invasive Gynecol 2020;27(2):408–418.e3. DOI: 10.1016/j.jmig.2019.11.001.
Pinzauti S, Lazzeri L, Tosti C, et al. Transvaginal sonographic features of diffuse adenomyosisin 18-30-year-old nulligravid women without endometriosis: Association with symptoms. Ultrasound Obstet Gynecol 2015;46(6):730–736. DOI: 10.1002/uog.14834.
Exacoustos C, Brienza L, Di Giovanni A, et al. Adenomyosis: Threedimensional sonographic findings of the junctional zone and correlation with histology. Ultasound Obstet Gynaecol 2011:37(4): 71–79. DOI: 10.1002/uog.8900.
Andres MP, Borrelli GM, Ribeiro J, et al. Transvaginal ultrasound for the diagnosis of adenomyosis: Systematic review and metanalysis. J Minim Invassive Gynaecol 2018;25(2):257–264. DOI: 10.1016/j.jmig.2017.08.653.
Sun YL, Wang CB, Lee CY, et al. Transvaginal sonographic criteria for the diagnosis of Adenomyosis based on histopathologic correlation. Taiwan J Obstet Gynecol 2010;49(1):40–44. DOI: 10.1016/S1028-4559(10)60007-1.
Kepkep K, Tuncay YA, Goynümer G, et al. Transvaginal sonography in the diagnosis of Adenomyosis: Which findings are most accurate? Ultrasound Obstet Gynecol 2007;30(3):341–345. DOI: 10.1002/uog.3985.