Reinhold C, Atri M, Mehio A, Zakarian R, Aldis A E, Bret P M
Department of Diagnostic Radiology, Montreal General Hospital, Quebec, Canada.
Radiology. 1995 Dec;197(3):609-14. doi: 10.1148/radiology.197.3.7480727.
To determine the accuracy of endovaginal ultrasound (US) in the diagnosis of uterine adenomyosis and to evaluate the frequency of observed sonographic criteria.
Endovaginal US was performed in 100 consecutive women undergoing hysterectomy for a variety of benign and malignant conditions. Adenomyosis was diagnosed when a poorly defined area of abnormal echotexture (decreased or increased echogenicity, heterogeneous echotexture, myometrial cysts) was present in the myometrium. All endovaginal US findings were correlated with those from histologic examination.
Endovaginal US depicted 25 of 29 pathologically proved cases of adenomyosis. Adenomyosis was correctly ruled out in 61 of 71 patients. Endovaginal US had a sensitivity of 86%, a specificity of 86%, and a positive and negative predictive value of 71% and 94%, respectively. Of the 25 patients with true-positive findings at US, the myometrium demonstrated heterogeneous and hypoechoic areas with or without the presence of cysts in 21 (84%) patients, hypoechoic areas with cysts in three (12%) patients, and heterogeneous areas within the myometrium in one (4%) patient.
Adenomyosis of the uterus can be accurately diagnosed with endovaginal US with use of specific sonographic criteria.
确定经阴道超声（US）诊断子宫腺肌病的准确性，并评估观察到的超声诊断标准的出现频率。
对100例因各种良性和恶性疾病接受子宫切除术的连续女性进行经阴道超声检查。当子宫肌层出现边界不清的异常回声区域（回声减低或增强、回声不均匀、肌层囊肿）时，诊断为子宫腺肌病。所有经阴道超声检查结果均与组织学检查结果进行对照。
经阴道超声检查显示29例经病理证实的子宫腺肌病患者中有25例。71例患者中61例被正确排除子宫腺肌病。经阴道超声检查的敏感性为86%，特异性为86%，阳性预测值和阴性预测值分别为71%和94%。在超声检查结果为真阳性的25例患者中，21例（84%）子宫肌层表现为不均匀低回声区，伴或不伴有囊肿；3例（12%）为低回声区伴囊肿；1例（4%）为子宫肌层内不均匀区。
使用特定的超声诊断标准，经阴道超声可准确诊断子宫腺肌病。
