Role of transvaginal sonography and magnetic resonance imaging in the diagnosis of uterine adenomyosis

Transvaginal sonography and magnetic resonance imaging allow assessment and classification of ad- enomyosis subtypes.

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Volume 109, Issue 3, Pages 389–397

Authors:

Marc Bazot, M.D., Emile Daraï, M.D., Ph.D.

Abstract:

The aim of the present review, conducted according to PRISMA statement recommendations, was to evaluate the contribution of transvaginal sonography (TVS) and magnetic resonance imaging (MRI) to diagnose adenomyosis. Although there is a lack of consensus on adenomyosis classification, three subtypes are described, internal, external adenomyosis, and adenomyomas. Using TVS, whatever the subtype, pooled sensitivities, pooled specificities, and pooled positive likelihood ratios are 0.72–0.82, 0.85–0.81, and 4.67–3.7, respectively, but with a high heterogeneity between the studies. MRI has a pooled sensitivity of 0.77, specificity of 0.89, positive likelihood ratio of 6.5, and negative likelihood ratio of 0.2 for all subtypes. Our results suggest that MRI is more useful than TVS in the diagnosis of adenomyosis. Further studies are required to determine the performance of direct signs (cystic component) and indirect signs (characteristics of junctional zone) to avoid misdiagnosis of adenomyosis.


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Editorial Office, American Society for Reproductive Medicine

Fertility and Sterility® is an international journal for obstetricians, gynecologists, reproductive endocrinologists, urologists, basic scientists and others who treat and investigate problems of infertility and human reproductive disorders. The journal publishes juried original scientific articles in clinical and laboratory research relevant to reproductive endocrinology, urology, andrology, physiology, immunology, genetics, contraception, and menopause. Fertility and Sterility® encourages and supports meaningful basic and clinical research, and facilitates and promotes excellence in professional education, in the field of reproductive medicine.

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