Transvaginal Ultrasound for the Diagnosis of Adenomyosis: Systematic Review and Meta-Analysis

Carregando...
Imagem de Miniatura
Citações na Scopus
118
Tipo de produção
article
Data de publicação
2018
Título da Revista
ISSN da Revista
Título do Volume
Editora
ELSEVIER SCIENCE INC
Citação
JOURNAL OF MINIMALLY INVASIVE GYNECOLOGY, v.25, n.2, p.257-264, 2018
Projetos de Pesquisa
Unidades Organizacionais
Fascículo
Resumo
Adenomyosis is characterized by the presence of ectopic foci of endometrial glandular tissue and/or stroma within the myometrium. The diagnosis of adenomyosis is traditionally made through histologic evaluation of the postsurgical specimen. More recently, imaging with transvaginal ultrasound (TVUS) has been used for the preoperative diagnosis of adenomyosis. As yet, there is no consensus regarding the best imaging feature or combination thereof for the nonsurgical diagnosis of adenomyosis. This study systematically evaluated the literature in the last 10 years to determine the accuracy of 2-dimensional (2D) TVUS, different imaging features, enhancing methods such as 3-dimensional (3D) TVUS, elastography and color Doppler in the nonsurgical diagnosis of adenomyosis. A total of 8 studies were included. Pooled sensitivity and specificity for 2D TVUS for the diagnosis of adenomyosis for all combined imaging characteristics was 83.8% and 63.9%, respectively. Pooled sensitivity for 355 total patients with use of imaging feature of heterogeneous myometrium with 2D TVUS was highest (86.0%), and pooled specificity for 283 total patients with use of globular uterus was highest (78.1%). After including the ""question mark"" sign with other TVUS features, higher sensitivity and specificity, of 92% and 88%, respectively, were noted. For 3D TVUS, pooled sensitivity and specificity for all combined imaging characteristics was 88.9% and 56.0%, respectively. Poor definition of junctional zone showed the highest pooled sensitivity (86%) and the highest pooled specificity (56.0%) for the diagnosis of adenomyosis with 3D TVUS. There was no improvement in overall accuracy in 3D TVUS compared with 2D TVUS. Preliminary results of TVUS with color Doppler showed a high sensitivity and specificity for the differentiation between adenomyosis and myomas (95.6% and 93.4%, respectively). Also, TVUS elastography in 1 study showed an improvement in specificity (82.9%) compared with 2D TVUS (63.9%), albeit with comparable sensitivity. Larger studies are needed to advance our understanding of the different types of adenomyosis and their clinical impact.
Palavras-chave
Transvaginal ultrasound, Adenomyosis, Ultrasonography, Doppler, Color, 3D imaging, Meta-analysis
Referências
  1. Abbott JA, 2017, BEST PRACT RES CL OB, V40, P68, DOI 10.1016/j.bpobgyn.2016.09.006
  2. Acar S, 2016, ULTRASOUND, V24, P205, DOI 10.1177/1742271X16673677
  3. Alabiso G, 2016, J MINIM INVAS GYN, V23, P476, DOI 10.1016/j.jmig.2015.12.017
  4. American Institute of Ultrasound in Medicine, 2014, J ULTRAS MED, V33, P1122
  5. AZZIZ R, 1989, OBSTET GYN CLIN N AM, V16, P221
  6. Bazot M, 2001, HUM REPROD, V16, P2427, DOI 10.1093/humrep/16.11.2427
  7. Bergeron C, 2006, BEST PRACT RES CL OB, V20, P511, DOI 10.1016/j.bpobgyn.2006.01.016
  8. Bergholt T, 2001, HUM REPROD, V16, P2418, DOI 10.1093/humrep/16.11.2418
  9. Di Donato N, 2015, Ultrasound Obstet Gynecol, V46, P126, DOI 10.1002/uog.14750
  10. Exacoustos C, 2011, ULTRASOUND OBST GYN, V37, P471, DOI 10.1002/uog.8900
  11. Garcia L, 2011, J MINIM INVAS GYN, V18, P428, DOI 10.1016/j.jmig.2011.04.004
  12. Gonzales M, 2012, GYNECOL SURG, V9, P259, DOI 10.1007/s10397-012-0746-4
  13. Hanafi Magdi, 2013, J Hum Reprod Sci, V6, P189, DOI 10.4103/0974-1208.121421
  14. Kepkep K, 2007, ULTRASOUND OBST GYN, V30, P341, DOI 10.1002/uog.3985
  15. Levgur M, 2000, OBSTET GYNECOL, V95, P688, DOI 10.1016/S0029-7844(99)00659-6
  16. Luciano DE, 2013, J MINIM INVAS GYN, V20, P803, DOI 10.1016/j.jmig.2013.05.002
  17. Moher David, 2015, Syst Rev, V4, P1, DOI 10.1186/2046-4053-4-1
  18. Naftalin J, 2016, ULTRASOUND OBST GYN, V47, P779, DOI 10.1002/uog.15798
  19. Pinzauti S, 2015, ULTRASOUND OBST GYN, V46, P730, DOI 10.1002/uog.14834
  20. Pistofidis G, 2014, CLIN EXP OBSTET GYN, V41, P113
  21. Sakhel K, 2012, J ULTRAS MED, V31, P805
  22. Sharma K, 2015, J CLIN DIAGN RES, V9, pQC8, DOI 10.7860/JCDR/2015/12240.5846
  23. Struble J, 2016, J MINIM INVAS GYN, V23, P164, DOI 10.1016/j.jmig.2015.09.018
  24. Sun YL, 2010, TAIWAN J OBSTET GYNE, V49, P40, DOI 10.1016/S1028-4559(10)60007-1
  25. Whiting Penny, 2003, BMC Med Res Methodol, V3, P25, DOI 10.1186/1471-2288-3-25
  26. Zamora Javier, 2006, BMC Med Res Methodol, V6, P31, DOI 10.1186/1471-2288-6-31