The Evaluation On MRI And US For The Diagnosis Of Adenomyosis

Objective In order to improve the diagnosis level of adenomyosis and select one better nonsurgical imaging method and modality of choice for diagnosis of adenomysis before surgery.Methods We selected 78 cases with adenomyosis as case and 122 cases with hysteromyoma as the control, who underwent hysterotomy and confirmed by the histopathologic examination in the Iwate hospital, Japan from August 1997 to Nov. 2000. The Magnetic Resonance Imaging (MRI) and B ultrasonography (US) scans of the 200 cases were read by three radiation doctors who did not know the results of the histopathologic examination according to the diagnosis standard and given one result of five ansews: yes, maybe, not clear, maybe not, and no. the results were Analysed by the receiver operating characteristic (ROC). The value was estimated of MRI and US by compared the area under the curve (Az). Results 1. The Az of US is 0.9157 and the Az of MRI is 0.9966. The difference between them is significant (p<0. 01). 2. The edge of foci of adenomyosis is not clear, and the frequency of diffusely thickened junctional zone (JZ) >= 12mm, coarse endometrial tissue, hyperintenivefoci within hypointensity focal lesions on T2WI and hypointensity on T1WI in adenomysis group are significant high than those in hystromyoma group (p<0.01). Conclus ion 1. MRI is a advantage modality of choice for the nonsurgical diagnosis of adenomyosis compared with US and it will improve the diagnosis level of adenomyosis. 2. The ill-defined margins hypointensity focal lesions, JZ>=12mm, coarse endometrial tissue and hyprintensity on T1WI of MRI features are the critical for the diagnosis of adenomyosis.