Comparing Accuracies of Transvaginal Ultrasonography and Magnetic Resonance Imaging for Nonsurgical Diagnosis of Adenomyosis

  • Sehrish Rubab Senior Registrar, Mayo Hospital Lahore
  • Asma Maqsood Senior Registrar, Pakistan Kidney and Liver Institute and Research Center
  • Muhammad Salman Rafique Consultant Radiologist, Pakistan Kidney and Liver Institute and Research Center
  • Sana Kundi Consultant Radiologist, Pakistan Kidney and Liver Institute and Research Center
  • Abeer Yasin Senior Registrar, Lahore General Hospital
  • Tuba Tariq Assistant Professor Radiology Department, Azra Naheed Medical College, Superior University
Keywords: Transvaginal Ultrasonography, Magnetic resonance Imaging


Objective: To compare the diagnostic accuracies of TVS and MRI in diagnosis of adenomyosis.

Methodology: A cross sectional study was conducted in Radiology Department of Sir Ganga Ram Hospital Lahore from July 2017 to Jan 2018. 120 females of age 38 to 50years fulfilling inclusion criteria were registered in the study. Patients undergone TVS with endovaginal probe of TOSHIBA Aplio and labeled as positive or negative for findings. Patients then had MRI and confirmed as positive or negative. Data was analyzed by SPSS 20. Sensitivity, specificity, PPV, NPV and accuracy were estimated for TVS and MRI by generating 2x2 contingency table.

Results: The mean age of the patients was demonstrated to be 44.2 ± 5.12 years. Frequency of  adenomyosis was revealed in 82 out of 120(68.3%) women who underwent TVS while 38 (31.7%) were negative. Conversely; at MRI 93 (77.5%) women had confirmation of adenomyosis and 27 (22.5%) were negative. Therefore, TVS sensitivity, specificity, PPV, NPV and accuracy was proven to be 82.8%, 81.5%, 93.9%, 57.9% and 82.5%, respectively for diagnosis of adenomyosis.

Conclusion: TVS and MRI have high diagnostic accuracies as a pre-operative diagnostic tools for adenomyosis. So we can recommend TVS in daily practice for screening and early diagnosis of adenomyosis and if findings are inconclusive or associated with other pelvic pathologies further MRI will result in best therapeutic outcome for patients. Results of this study will help in future for easy and unchallenging diagnosis of adenomyosis and will improve our clinical practice and local guidelines.

Original Articles