ABSTRACT
To measure the accuracy of combined two dimensional [2D] trans-vaginal ultrasound [TVS] and color Doppler in diagnosis of adenomyosis uteri and to assess the role of Doppler indices of the uterine arteries in diagnosis of adenomyosis. A cross-sectional observational study. One hundred women complaining of pelvic pain and or uterine bleeding and were clinically and sonographically diagnosed to have adenomyosis and scheduled for hysterectomy were approached for participation. Eighty patients were recruited and subjected to color and uterine artery Doppler studies [systolic/ diastolic [S/D] ratio, resistance and pulsatility index [RI and PI] in a trial to diagnose adenomyosis. The finding of 2D-TVS and color Doppler were compared to a gold standard of histopathology of the retrieved uterine specimens. Sensitivity, specificity, positive and negative predictive values were measured. Fifty specimens out of 80 uteri histologically confirmed to have adenomyosis by histopathology. Sensitivity, specificity, positive predictive value, negative predictive value and overall accuracy of the 2D-TVS in the diagnosis of adenomyosis were 76.0%, 83.3%, 88.4%, 67.6% and 78.8%, respectively. However, for combined 2D-TVS and the color-Doppler ultrasound the figures were 86.0%, 86.67%, 91.5%, 78.8% and 86.3%, respectively. Myometrial cysts were the most commonly diagnosed [53.8%] ultrasonographic criteria. However, uterine artery S/D, RI and PI showed no significant association with adenomyosis. Combined 2D-TVS and color Doppler ultrasound is superior to 2D-TVS alone in diagnosis of adenomyosis. Uterine artery Doppler study was of no diagnostic value in adenomyosis