Diagnostic accuracy of transvaginal sonography for the diagnosis of adenomyosis: systematic review and metaanalysis.
OBJECTIVE
The purpose of this study was to critically appraise the diagnostic accuracy of transvaginal sonography for diagnosing adenomyosis.


METHODS
Computerized databases were used to identify relevant reports published between 1966 and 2007 reporting data on the accuracy of transvaginal sonography for diagnosing adenomyosis in women having hysterectomy. The presence or absence of adenomyosis was confirmed by histopathologic analysis of hysterectomy specimens. The total analysis included 14 trials with 1895 aggregate participants. Two authors independently assessed methodological quality and constructed tables for the assessment of diagnostic measures.


RESULTS
Transvaginal ultrasound predicted adenomyosis with a likelihood ratio of 4.67 (95% confidence interval [CI], 3.13-6.17). The overall prevalence of adenomyosis was 27.9% (95% CI, 25.5-30.3). The probability of adenomyosis with an abnormal transvaginal ultrasound was 66.2% (95% CI, 61.6- 70.6). The probability of adenomyosis with a normal transvaginal ultrasound was 9.1% (95% CI, 7.3-11.1).


CONCLUSIONS
Transvaginal sonography appears to be an accurate diagnostic test for adenomyosis.
Meredith
Susanna M
SM
Department of Obstetrics and Gynecology, University of Florida College of Medicine, Jacksonville, FL, USA.
Sanchez-Ramos
Luis
L
Kaunitz
Andrew M
AM
D019540:Area Under Curve; D004715:Endometriosis / Q000000981:diagnostic imaging* / Q000473:pathology; D019160:Endosonography / Q000379:methods; D005260:Female; D006801:Humans; D016013:Likelihood Functions; D011247:Pregnancy; D012680:Sensitivity and Specificity; D014621:Vagina / Q000000981:diagnostic imaging