Diffuse adenomyosis: comparison of endovaginal US and MR imaging with histopathologic correlation.
OBJECTIVE
To compare the accuracy of endovaginal ultrasound (US) and magnetic resonance (MR) imaging in the diagnosis of adenomyosis.


METHODS
The authors prospectively studied 119 consecutive patients undergoing hysterectomy. The endovaginal US scans and MR images were interpreted independently in a double-blind fashion. Imaging findings were compared with those at histopathologic examination.


RESULTS
At histopathologic examination, adenomyosis was found in 28 of the 119 patients (24%). Sensitivity and specificity was 89% for endovaginal US and 89% for MR imaging. The positive predictive value was 71% for US and 65% for MR imaging. The negative predictive value was 96% for US and 95% for MR imaging. There was no statistically significant difference between the sensitivities (P = .65) and specificities (P = .75) of endovaginal US and MR imaging. The mean junctional zone (JZ) thickness on MR images in patients with and without proved adenomyosis was 15.0 mm +/- 4.9 and 7.7 mm +/- 3.3, respectively (P < .0001). When receiver operating characteristic curves were applied retrospectively, the optimal JZ value for the diagnosis of adenomyosis with MR imaging was > or = 12 mm.


CONCLUSIONS
Endovaginal US was as accurate as MR imaging in the diagnosis of uterine adenomyosis. Use of a JZ thickness of > or= 12 mm should further optimize the diagnostic accuracy of MR imaging.
Reinhold
C
C
Department of Diagnostic Radiology, Montreal General Hospital, McGill University School of Medicine, Quebec, Canada.
McCarthy
S
S
Bret
P M
PM
Mehio
A
A
Atri
M
M
Zakarian
R
R
Glaude
Y
Y
Liang
L
L
Seymour
R J
RJ
D004311:Double-Blind Method; D004715:Endometriosis / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000453:epidemiology; D005260:Female; D006801:Humans; D007044:Hysterectomy; D016015:Logistic Models; D008279:Magnetic Resonance Imaging / Q000379:methods; D008875:Middle Aged; D009215:Myometrium / Q000473:pathology; D011237:Predictive Value of Tests; D011300:Preoperative Care; D011446:Prospective Studies; D012372:ROC Curve; D012680:Sensitivity and Specificity; D014463:Ultrasonography / Q000379:methods; D014591:Uterine Diseases / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000453:epidemiology