Accuracy of 2d-tvs in adenomyosis diagnosis

Adenomyosis is benign debilitating disease of endometrium. It presents with non-specific clinical features like chronic pelvic pain, dysmenorrhea and heavy menstrual blood loss. Diagnosis of adenomyosis with non-invasive tools like ultrasound and magnetic resonance imaging (MRI) are available. Pre op diagnosis helps in proper management of symptoms. There is debate regarding accuracy of these tools. Ultrasound is an inexpensive and readily available tool as compared to MRI. Histopathology of uterine specimen is gold standard for adenomyosis confirmation.
Material and Methods: Cross sectional study carried out in tertiary care hospital. One hundred and thirty three cases with non- specific clinical features of adenomyosis were included in study. These cases underwent 2-D transvaginal ultrasound and later on hysterectomy. Histopathology of Uterine specimen used for final confirmation of 2D-TVS diagnosis of adenomyosis.
Results: Out of 133 women 38 were diagnosed as cases of adenomyosis on 2D-TVS. On histopathology 30 (True Positive) were confirmed and 8 were not found to have adenomyosis (False Positive). Out of 95 cases with no feature of adenomyosison 2D-TVS 2 (False Negatine) were found cases of adenomyosis on histopathology. Validity of 2D-TVS for adenomyosis diagnosis taking histopathology as gold standard is sensitivity 93.8%, specificity 92.1%, PPV 78.9%, NPV 97.9% and accuracy 92.5%.
Conclusion:2D-TVS have strong validity for pre op diagnosis of adenomyosis.