Diagnosing adenomyosis using transvaginal ultrasound in current practice: a scoping review and service evaluation

Smith, Dawn ORCID: https://orcid.org/0009-0003-9817-5959 and Bolton, Gareth ORCID: https://orcid.org/0000-0002-5453-4257 (2025) Diagnosing adenomyosis using transvaginal ultrasound in current practice: a scoping review and service evaluation. Ultrasound .

Preview

PDF - Accepted Version Available under License CC BY-NC Download (872kB) | Preview

Abstract

Background: A departmental audit identified a case of adenomyosis which had not been reported, highlighting the need to assess if the current service provision is adequate in identifying patients with (possible) adenomyosis and how improvements in this part of the service could be made.

Aim: To assess if sonographers are effectively identifying and reporting adenomyosis on transvaginal ultrasound.

Methodology: A scoping review and retrospective service evaluation was undertaken which included (n=79) adult female premenopausal patients with symptoms of adenomyosis who had undergone a transvaginal ultrasound scan during the first quarter of 2023. Patients were identified using the CRIS statistic module according to pre-defined inclusion and exclusion criteria. All data was anonymised and collated to include the patient age, referral information (symptoms), scan report and sonographer. The scan report and archived images were evaluated using the sonographic signs identified by the Morphological Uterus Sonographic Assessment (MUSA) group (Harmsen et al., 2022), then compared to the original report.

Results: 21.5% (n=17) of patients had signs of adenomyosis on image review, but only 23.5% (n=4) of these were reported as such. The majority (n=8) of unidentified cases were reported as having a ‘heterogeneous myometrium’. Inter-rater agreement ranged from 50-100%.

Conclusion: Most ultrasonic diagnoses of adenomyosis were not identified in our service which is likely due to a lack of internationally agreed criteria for ultrasound diagnosis of adenomyosis preventing adequate reporting.

Item Type:	Article
Journal / Publication Title:	Ultrasound
Publisher:	SAGE Publications
ISSN:	1743-1344
Departments:	Institute of Health > Medical Sciences
Additional Information:	Dr Gareth Charles Bolton, MSc Medical Imaging (Ultrasound) Programme Leader, University of Cumbria, UK. Dawn Smith, Southport and Ormskirk Hospitals, Mersey and West Lancashire NHS Teaching Hospitals, UK.
Depositing User:	Gareth Bolton
Date Deposited:	23 Apr 2025 10:54
Last Modified:	20 May 2025 09:15
URI:	https://insight.cumbria.ac.uk/id/eprint/8783

Downloads