Diagnostic Accuracy of Ultrasonography in Diagnosing Uterine Adenomyosis Using Magnetic Resonance Imaging as the Gold Standard
DOI:
https://doi.org/10.54112/bcsrj.v6i5.2277Keywords:
Adenomyosis; Diagnostic accuracy; Magnetic resonance imaging; Transvaginal ultrasound; Uterine diseases.Abstract
Uterine adenomyosis is a common benign gynecological disorder that may present with dysmenorrhea, abnormal uterine bleeding, and chronic pelvic pain. Magnetic resonance imaging is considered a reliable reference standard, while ultrasonography remains a widely available first-line diagnostic modality. Objective: To determine the diagnostic accuracy of ultrasonography in diagnosing of uterine adenomyosis keeping magnetic resonance imaging as gold standard. Methods: This study was conducted on 215 females aged 18 to 45 years with suspected adenomyosis. Patients who had recent uterine surgery, uterine fibroids, pelvic inflammatory disease, and tubal pathology were excluded from the study. All patients underwent transvaginal ultrasound, which was followed by pelvic MRI. Diagnostic accuracy including sensitivity, specificity, positive predictive value, and negative predictive value, were calculated using a 2×2 contingency table, keeping the MRI as gold standard. SPSS 25 was used for analysis. Stratification was performed using chi square test, keeping significance level at 5%. Results: The mean age of 215 patients in this study was 30.17±7.84 years and their mean body mass index was 26.86±2.65 kg/m2. MRI showed positive adenomyosis in 136 patients (63.3%), which ultrasound was positive for adenomyosis in 115 (53.5%) patients. Ultrasonography exhibited sensitivity of 69.12%, specificity 73.42%, positive predictive value of 81.74%, negative predictive value 58.00%, and diagnostic accuracy 70.70%. Conclusion: The diagnostic accuracy of ultrasonography in diagnosing uterine adenomyosis keeping magnetic resonance imaging as gold standard was 70.70%, with sensitivity 69.12% and specificity 73.42%.
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