Ultrasound Diagnosis of Adenomyosis: A Literature Review and Clinical Cases

This review addresses the utility of ultrasound in the diagnosis of adenomyosis. Over the past 45 years, the topic has been extensively covered in the literature. To date, at least 20 ultrasound criteria for adenomyosis have been proposed by various research groups. Currently, the most clinically relevant are the direct and indirect ultrasound features of adenomyosis as delineated by the MUSA (Morphological Uterus Sonographic Assessment) international consensus. Reported diagnostic value for ultrasound in adenomyosis detection vary across studies: sensitivity ranges from 72 % to 91 %, specificity from 49 % to 90 %, positive predictive value (PPV) from 72 % to 82 %, negative predictive value (NPV) from 49 % to 80 %, and accuracy from 56 % to 63 %. A correlation between ultrasound findings and clinical manifestations of adenomyosis has been described (including an association between the severity of symptoms and the number of detected imaging features), although this relationship remains a subject of debate among experts.

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