title: Accuracy of Hysteroscopic Endomyometrial Biopsy in Diagnosis of Adenomyosis.
abstract: OBJECTIVE
  To investigate the diagnostic accuracy of endomyometrial biopsy obtained via office hysteroscopy for the diagnosis of adenomyosis.
  
  
  METHODS
  Cross-sectional study.
  
  
  METHODS
  Cairo University Teaching Hospital, Cairo, Egypt.
  
  
  METHODS
  A total of 404 premenopausal women with symptoms clinically suggestive of having adenomyosis.
  
  
  METHODS
  All patients were subjected to 2-dimensional transvaginal sonography (TVS) in-office hysteroscopy examination with endomyometrial biopsy. Patients who subsequently underwent hysterectomy were included in the final analysis.
  
  
  RESULTS
  Accuracy of diagnostic modalities was represented using the terms sensitivity, specificity, positive predictive value, negative predictive value, and overall accuracy. A total of 292 patients were eligible for final analysis. Of these, 162 (55.47%) were diagnosed with adenomyosis based on hysterectomy specimens. TVS had a high sensitivity (83.95%) and a moderate specificity (60%). In contrast, endomyometrial biopsy was more specific (78.46%) than sensitive (54.32%). Hysteroscopic appearance of the endometrial cavity had low sensitivity (40.74%) and specificity (44.62%). Adding endomyometrial biopsy to TVS improved specificity (89.23%).
  
  
  CONCLUSIONS
  Endomyometrial biopsy obtained via office hysteroscopy can diagnose adenomyosis with a high specificity and is recommended after TVS.
authors.affiliation: Department of Obstetrics and Gynecology, Cairo University, Cairo, Egypt. Electronic address: dinadakhly@gmail.com.
authors.forename: Dina M R
authors.initials: DM
authors.lastname: Dakhly
authors.affiliation: Department of Obstetrics and Gynecology, Cairo University, Cairo, Egypt.
authors.forename: Ghada A F
authors.initials: GA
authors.lastname: Abdel Moety
authors.affiliation: Department of Obstetrics and Gynecology, Cairo University, Cairo, Egypt.
authors.forename: Waleed
authors.initials: W
authors.lastname: Saber
authors.affiliation: Department of Obstetrics and Gynecology, Cairo University, Cairo, Egypt.
authors.forename: Sherine H
authors.initials: SH
authors.lastname: Gad Allah
authors.affiliation: Department of Obstetrics and Gynecology, Cairo University, Cairo, Egypt.
authors.forename: Ahmed T
authors.initials: AT
authors.lastname: Hashem
authors.affiliation: Department of Pathology, Faculty of Medicine, Cairo University, Cairo, Egypt.
authors.forename: Lubna O E
authors.initials: LO
authors.lastname: Abdel Salam
mesh_terms: D062788:Adenomyosis / Q000175:diagnosis* / Q000473:pathology / Q000601:surgery; D000328:Adult; D000556:Ambulatory Surgical Procedures; D003430:Cross-Sectional Studies; D004534:Egypt; D004717:Endometrium / Q000000981:diagnostic imaging / Q000473:pathology*; D005260:Female; D006801:Humans; D007044:Hysterectomy / Q000706:statistics & numerical data*; D015907:Hysteroscopy / Q000379:methods; D017697:Premenopause; D012017:Referral and Consultation; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D014463:Ultrasonography; D014621:Vagina / Q000000981:diagnostic imaging*
keywords: Adenomyosis; Endomyometrial biopsy; Office hysteroscopy; Sensitivity; Specificity