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Adenomyosis: US features with histologic correlation in an in-vitro study.

M Atri·C Reinhold·A R Mehio·W B Chapman·P M Bret
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Abstract

PURPOSE: To evaluate the accuracy of ultrasonographic (US) features of adenomyosis by correlating them with histologic findings and to assess inter- and intraobserver agreement. MATERIALS AND METHODS: US was performed and videotaped in 102 consecutive hysterectomy specimens in a water bath. Videotapes were reviewed initially by two independent radiologists blinded to the clinical and histologic findings and after 1 month by one of the two; US and histologic findings were correlated. Features evaluated included diffuse abnormal echotexture of myometrium, subendometrial myometrial cysts, subendometrial echogenic nodules, subendometrial echogenic linear striations, nodular endometrial-myometrial junction, poor definition of the endometrial-myometrial junction, asymmetric thickness of the anteroposterior wall of the myometrium, and globular configuration. RESULTS: The prevalence of adenomyosis in this cohort was 29.4% (30 of 102 specimens). The mean sensitivity, specificity, negative predictive value, positive predictive value (PPV), and accuracy for the diagnosis of adenomyosis for the three reviews were 81%, 71%, 90%, 54%, and 74%, respectively. All findings evaluated, except for nodular endometrial-myometrial junction, were significantly more common in uteri with adenomyosis (P <.05). Heterogeneous myometrium reached borderline significance (P =.05). The specificities and PPVs of subendometrial striations, subendometrial echogenic nodules, and asymmetric myometrial thickness were significantly higher than those of other features (P <.05). The interobserver agreement was moderate (kappa = 0.48), and the intraobserver agreement was good (kappa = 0. 67) for the three reviews. CONCLUSION: The presence of subendometrial linear striations, subendometrial echogenic nodules, or asymmetric myometrial thickness improves the specificity and PPV of US in diagnosing adenomyosis.

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AdultAgedAged, 80 and overConfidence IntervalsDiagnosis, DifferentialEndometriosisFemaleHumansIn Vitro TechniquesMiddle AgedObserver VariationOdds RatioProspective StudiesRetrospective StudiesSensitivity and SpecificityStatistics, NonparametricUltrasonographyUterine DiseasesUterusComparative StudyJournal Article

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M Atri, C Reinhold, A R Mehio, W B Chapman, P M Bret. 2000. Adenomyosis: US features with histologic correlation in an in-vitro study.. https://doi.org/10.1148/radiology.215.3.r00jn06783

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