The accuracy of transvaginal ultrasound and uterineartery doppler in the diagnosis of adenomyosis

Abstract EN

To measure the accuracy of combined two dimensioml (2D) trans-vagiml ultrasound (TVS) and color Doppler in diagnosis of adenomyosis uteri and to assess the rôle of Doppler indices of the uterine arteries in diagnosis of adenomyosis.

Study design: A cross-sectional observational study.

Materials and methods: One hundred women complaining of pelvic pain and or uterine bleeding and were clinically and sonographically diagnosed to have adenomyosis and scheduled for hysterectomy were approached for participation.

Eighty patients were recruited and subjected to color and uterine artery Doppler studies {systolic/ diastolic (S/D) ratio, résistance and pulsatility index (RI and PI} in a trial to diagnose adenomyosis.

The fmding of 2D-TVS and color Doppler were compared to a gold standard of histopathology of the retrieved uterine specimens.

Sensitivity, specificity, positive and negative prédictive values were measured.

Results:Fifty specimens out of 80 uteri histologically confirmed to have adenomyosis by histopathology.

Sensitivity, specificity, positive prédictive value, negative prédictive value and overall accuracy'of the 2D-TVS in the diagnosis of adenomyosis were76.0%, 83,3%, 88.4%, 67.6% and 78.8%, respectively.

However, for combined 2D-TVS and the color-Doppler ultrasound the figures were 86.0%, 86.67%, 91.5%, 78.8%> and 86.3%, respectively.

Myométrial cysts were the most commonly diagnosed (53.8%)ultrasonographic criteria.

However, uterine artery S/D, RI and PI showed no significant association with adenomyosis.

Conclusion:Combined 2D-TVS and color Doppler ultrasound is superior to 2D-TVS alone in diagnosis of adenomyosis.

Uterine artery Doppler study was of no diagnostic value in adenomyosis.