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Transvaginal ultrasound or MRI for diagnosis of adenomyosis

Dueholm, Margita; Lundorf, Erikb

Current Opinion in Obstetrics and Gynecology: December 2007 - Volume 19 - Issue 6 - p 505–512
doi: 10.1097/GCO.0b013e3282f1bf00
Women's health: Edited by Gubby Ayida and Joseph Aquilina

Purpose of review Transvaginal ultrasound and MRI are used to diagnose adenomyosis. This review summarizes the current evidence on the diagnostic accuracy of these techniques.

Recent findings The image resolution of both transvaginal ultrasound and MRI is effective for the diagnosis of adenomyosis. In a limited number of well-designed studies the diagnostic efficiency of MRI and transvaginal ultrasound were almost in line. With transvaginal ultrasound, considerable training is needed to recognize the distinct ultrasound pattern in the diagnosis of adenomyosis. The findings in MRI are less observer dependent, but still somewhat dependent on an MRI observer who is expert in gynecologic imaging.

Summary Transvaginal ultrasound is the natural first choice of image modality when investigating pelvic pain or menstrual disorders, but correct diagnosis of adenomyosis is dependent on sonographers trained in pattern recognition of adenomyosis. When transvaginal ultrasound provides indefinite findings or when dealing with difficult cases with coexistence of other abnormalities (myomas and severe endometriosis), MRI may add information and increase the diagnostic performance.

aDepartment of Gynecology and Obstetrics, Denmark

bDepartment of Magnetic Resonance Imaging, Aarhus University Hospital, Aarhus, Denmark

Correspondence to Margit Dueholm, Department of Gynecology and Obstetrics, Aarhus University Hospital, DK-8000 Aarhus, Denmark Tel: +45 89495566; fax: +45 89496364; e-mail:

© 2007 Lippincott Williams & Wilkins, Inc.