Journal of Ultrasound in Medicine, Vol 6, Issue 7 345-349, Copyright © 1987 by American Institute of Ultrasound in Medicine
Uterine adenomyosis. A difficult sonographic diagnosis
D. Siedler, F. C. Laing, R. B. Jeffrey Jr and V. W. Wing
In an effort to distinguish the appearance of generalized uterine
adenomyosis from leiomyoma, a retrospective study was performed on 80
patients who had preoperative uterine sonography. A diagnosis of
adenomyosis (eight patients) was suggested if the uterus was diffusely
enlarged, but the myometrial texture, contour, and central cavity echoes
were each normal. Leiomyoma, or other focal uterine pathology (72 patients)
was characterized by focal or globular uterine enlargement with abnormal
echo texture and contour, as well as nonvisualization or displacement of
the central cavity echo complex. Using these criteria, ultrasound was able
to suggest adenomyosis with a sensitivity of 63%, a specificity of 97%, and
a positive predictive value of 71%. Focal pathology was diagnosed with a
sensitivity of 97%, a specificity of 63%, and a positive predictive value
of 96%. Although irregular myometrial sonolucent zones have previously been
reported as characteristic for adenomyosis, this study did not confirm this
finding.
