DIFFUSE ADENOMYOSIS - COMPARISON OF ENDOVAGINAL US AND MR-IMAGING WITH HISTOPATHOLOGIC CORRELATION

PURPOSE: To compare the accuracy of endovaginal ultrasound (US) and ma gnetic resonance (MR) imaging in the diagnosis of adenomyosis. MATERIA LS AND METHODS: The authors prospectively studied 119 consecutive pati ents undergoing hysterectomy. The endovaginal US scans and MR images w ere interpreted independently in a double-blind fashion. Imaging findi ngs were compared with those at histopathologic examination. RESULTS: At histopathologic examination, adenomyosis was found in 28 of the 119 patients (24%). Sensitivity and specificity was 89% for endovaginal U S and 89% for MR imaging. The positive predictive value was 71% for US and 65% for MR imaging. The negative predictive value was 96% for US and 95% for MR imaging. There was no statistically significant differe nce between the sensitivities (P = .65) and specificities (P = .75) of endovaginal US and MR imaging. The mean junctional zone (JZ) thicknes s on MR images in patients with and without proved adenomyosis was 15. 0 mm +/- 4.9 and 7.7 mm +/- 3.3, respectively (P < .0001). When receiv er operating characteristic curves were applied retrospectively, the o ptimal JZ value for the diagnosis of adenomyosis with MR imaging was g reater than or equal to 12 mm. CONCLUSION: Endovaginal US was as accur ate as MR imaging in the diagnosis of uterine adenomyosis. Use of a JZ thickness of greater than or equal to 12 mm should further optimize t he diagnostic accuracy of MR imaging.