Diagnostic Accuracy of Ultrasound in the Diagnosis of Adenomyosis

Aim and background:There is no reliable method to diagnose adenomyosis preoperatively. Recently, ultrasound has been suggested as a method to diagnose adenomyosis. The purpose of this study was to find out the accuracy of ultrasound in the diagnosis of adenomyosis. The objective of the study was to find the diagnostic accuracy of various features mentioned in morphological uterus sonographic assessment (MUSA) criteria by ultrasonography. Materials and methods: Patients undergoing hysterectomy for abnormal uterine bleeding over 12 months underwent the study. A transvaginal ultrasound was done preoperatively to diagnose adenomyosis using MUSA criteria. Postoperatively, histopathology was done to diagnose adenomyosis. All parameters mentioned in the MUSA criteria were analyzed to find the sensitivity and specificity of MUSA criteria in diagnosing adenomyosis. Results: Among the MUSA criteria, the highest sensitivity was for sunray appearance (80.85%) and asymmetrical thickening of the myometrium (80.85%). The highest specificity was for subendothelial lines (96.55%), translesional vascularity (93.10%), and hyperechoic islands (93.10%). Conclusion: Among the MUSA criteria, sunray appearance and asymmetrical thickening of myometrium are very sensitive markers of adenomyosis. Clinical significance: The MUSA criteria are a good marker for diagnosing adenomyosis preoperatively.