Magnetic resonance imaging and transvaginal ultrasonography for the diagnosis of adenomyosis
Open accessAbstract
Objective To compare the diagnostic potential of magnetic resonance imaging (MRI) and transvaginal ultrasonography (TVS) in the diagnosis of adenomyosis.Design Double blind set-up.Setting University medical school.Patient(s) We studied 106 consecutive premenopausal women who underwent hysterectomy for benign reasons.Intervention(s) Transvaginal ultrasonography and MRI were compared with histopathologic examination as the golden standard.Main outcome measure(s) Adenomyosis.Result(s) Twenty-two (21%) patients had adenomyosis. The sensitivity and specificity were as follows: sensitivity: MRI 0.70 (0.46-0.87) and TVS 0.68 (0.44-0.86) (P=.66); specificity: MRI 0.86 (0.76-0.93) and TVS 0.65 (0.50-0.77) (P=.03). The combination of MRI and TVS was most sensitive (0.89 [0.64-0.98]), but produced the lowest specificity (0.60 [0.44-0.73]). Adenomyosis was not detected by either MRI or TVS at uterine volumes >400 mL. Exclusion of uteri >400 mL from the analysis improved the diagnostic precision of MRI, but not that of TVS. The diagnostic accuracy at MRI was improved by calculating the maximum difference between the thinnest and thickest junctional zone (JZdif) (i.e., > or =5-7 mm).Conclusion(s) Magnetic resonance imaging was superior to TVS for the diagnosis of adenomyosis. Magnetic resonance imaging had a higher specificity than TVS, but their sensitivities were in line. The diagnostic accuracy of MRI, as that of TVS, was at an intermediate level, but the diagnostic accuracy of the former improved by exclusion of uteri >400 mL. The combination of MRI and TVS produced the highest level of accuracy for exclusion of adenomyosis, but the low specificity may necessitate further investigation of positive findings. Measurement of the difference in junctional zone thickness may optimize the diagnosis of adenomyosis at MRI.
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There is a significant association of pelvic endometriosis with uterine adenomyosis in women and in the baboon with life-long infertility.
“There is a significant association of pelvic endometriosis with uterine adenomyosis in women and in the baboon with life-long infertility.”
From The pathophysiology of endometriosis and adenomyosis, tissue injury and repair (2009) · cites this paper as [25]
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- Authors
- Dueholm, M., Lundorf, E., Hansen, E. S., Sørensen, J. S., Ledertoug, S., & Olesen, F.
- Affiliations
- Aarhus University (DK)
- Corresponding author
- Dueholm, Margit
- Venue
- Fertility and Sterility
- Publisher
- Elsevier BV
- Published
- 2001-09
- Volume
- 76
- Issue
- 3
- Pages
- 588-594
- ISSN
- 0015-0282 (ISSN-L)
- OpenAlex
- W1966951938
- Cited by
- 273
- References
- 25
- Citations by year
- 2026: 7 · 2025: 9 · 2024: 10 · 2023: 13 · 2022: 15 · 2021: 16 · 2020: 13 · 2019: 22 · 2018: 10 · 2017: 10 · 2016: 13 · 2015: 15 · 2014: 15 · 2013: 9 · 2012: 12
- FWCI
- 3.22
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Licence
- Locations
- Fertility and Sterility (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Reproductive Medicine › Endometriosis Research and Treatment
- Health Sciences › Medicine › Obstetrics and Gynecology › Gynecological conditions and treatments
- Health Sciences › Medicine › Obstetrics and Gynecology › Uterine Myomas and Treatments
- Keywords
- adenomyosis, magnetic resonance imaging, transvaginal ultrasound, diagnostic accuracy, sensitivity and specificity, uterine volume, premenopausal women, hysterectomy, histopathological diagnosis
- MeSH terms
- Adult, Double-Blind Method, Endometriosis, Female, Humans, Hysterectomy, Magnetic Resonance Imaging, Middle Aged, Myometrium, Sensitivity and Specificity, Ultrasonography, Vagina, Reproducibility of Results, Observer Variation, Premenopause
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