Keywords
transvaginal sonography
endometriosis
diagnostic imaging
histopathology
How to Cite
Abstract
Introduction: In the evaluation of pelvic pain and menstrual disorders, transvaginal ultrasound remains the imaging modality of choice. However, accurate diagnosis of adenomyosis depends on the expertise of the sonographer in identifying its characteristic features. With ongoing advancements in sonographic technology, the detection of adenomyosis has become increasingly reliable, enabling clinicians to offer more precise and individualized treatment.
Objective: To evaluate the diagnostic performance of transvaginal sonography in identifying adenomyosis, with histopathological findings serving as the reference standard.
Materials and Methods: This cross-sectional validation study was conducted at the Diagnostic Radiology and Pathology Departments, Wah Medical College / POF Hospital, Wah Cantt, over a period from August 2018 to August 2019. A total of 101 female patients presenting with heavy menstrual bleeding were enrolled. All underwent surgical intervention, after which specimens were sent for histopathological examination. Histopathological findings, interpreted by a consultant pathologist, were compared with preoperative sonographic results.
Results: The participants had a mean age of 38.3 ± 5.5 years. In comparison to histopathology, transvaginal sonography demonstrated a sensitivity of 88.0%, specificity of 92.1%, positive predictive value of 78.5%, negative predictive value of 95.8%, and an overall diagnostic accuracy of 91.0%.
Conclusion: Sonography demonstrates high diagnostic accuracy in the detection of adenomyosis. Attention to both common and atypical sonographic features is crucial for improving diagnostic confidence and outcomes.