Transvaginal ultrasonography in the diagnosis of diffuse adenomyosis.

OBJECTIVE

To evaluate the diagnostic capability of transvaginal ultrasonography in detecting diffuse adenomyosis.

DESIGN

We compared the preoperative transvaginal ultrasound (US) findings and the pathological findings of the surgical specimen in a series of women who underwent hysterectomy for menorrhagia.

PATIENTS: Forty-three women (mean [+/- SD] age of 46 +/- 5) with recurrent menorrhagia and enlarged uterus, without evidence of uterine leiomyomas at abdominal US and of endometrial disease at vabra curettage.

SETTING

Tertiary care center, university medical school.

MAIN OUTCOME MEASURES: Sensitivity, specificity, predictive positive and negative values of transvaginal US in the diagnosis of diffuse adenomyosis.

RESULTS

The sonographer diagnosed adenomyosis in 22 patients, whereas the pathologist found adenomyosis in 20 women, confirming the US findings in 16 cases and making an ex novo diagnosis in 4. The sensitivity of transvaginal US was 80%, the specificity 74%, the predictive value of a normal test 81%, and that of an abnormal test 73%.

CONCLUSIONS

Transvaginal US seems to represent a real advance in the preoperative diagnosis of diffuse adenomyosis.