To study the degree of interobserver agreement for already known
two-dimensional (2D) and three-dimensional (3D) sonography criteria of
adenomyosis.
Methods
Fifty cases (25 adenomyosis cases, 25 non-adenomyosis cases) were studied by
four expert observers and a less-experienced researcher. Each sonographic
adenomyosis criterion was separately studied. Interobserver agreement was
analysed by the kappa index with 95% confidence interval (CI).
Results
The degree of agreement about diagnosing adenomyosis was high or very high in
all pair-wise comparisons (kappa values of 0.58–0–92).
The agreement on identifying intra-myometrial cysts (kappa values of
0.46–0.79) and evaluating the junctional zone (JZ) by 3D-transvaginal
ultrasound (3D-TVS) (kappa index of 0.46–0.88) was good. The agreements
reached when evaluating the other criteria varied, but good agreement was
generally reached.
Conclusions
Both the 2D-TVS and 3D-TVS criteria employed in diagnosing adenomyosis were
reproducible parameters in adenomyosis diagnostics. The results were
reproducible, even by a less experienced observer.
BirdC.C., McElinT.W.,
Manalo-EstrellaP.The elusive adenomyosis of the uterusrevisited.
Am J Obstet Gynecol.1972; 112(5):
583–593.
2.
FerenczyA.Pathophysiology of adenomyosis. Hum
Reprod Update.1998; 4(4):
312–322.
3.
SammourA., PirwanyI., UsubutunA., ArseneauJ., TulandiT.Correlations between extent and spread of adenomyosis and
clinical symptoms. Gynecol Obstet Invest.2002; 54(4):
213–216.
4.
PinzautiS., LazzeriL., TostiC.Transvaginal sonographic features of diffuse adenomyosis in
1830-year-old nulligravid women without endometriosis: association with
symptoms. Ultrasound Obstet Gynecol.2015; 46(6):
730–736.
5.
KisslerS., HamschoN., ZangosS.Uterotubal transport disorder in adenomyosis and endometriosisa
cause for infertility. BJOG.2006; 113(8):
902–908.
6.
MaheshwariA., GurunathS., FatimaF., BhattacharyaS.Adenomyosis and subfertility: a systematic review of prevalence,
diagnosis, treatment and fertility outcomes. Hum
Reprod Update.2012; 18(4):
374–392.
7.
TomassettiC., MeulemanC., TimmermanD., DHoogheT.Adenomyosis and subfertility: evidence of association and
causation. Semin Reprod Med.2013; 31(2):
101–108.
8.
GordtsS., BrosensJ.J., FusiL., BenagianoG., BrosensI.Uterine adenomyosis: a need for uniform terminology and consensus
classification. Reprod Biomed Online.2008; 17(2):
244–248.
DueholmM., LundorfE.Transvaginal ultrasound or MRI for diagnosis of
adenomyosis. Curr Opin Obstet Gynecol.2007; 19(6):
505–512.
11.
MeredithS.M.,
Sanchez-RamosL., KaunitzA.M.Diagnostic accuracy of transvaginal sonography for the diagnosis
of adenomyosis: systematic review and meta-analysis.
Am J Obstet Gynecol.2009; 201(1):
107e1–e6.
12.
ChampaneriaR., AbedinP., DanielsJ., BalogunM., KhanK.S.Ultrasound scan and magnetic resonance imaging for the diagnosis
of adenomyosis: systematic review comparing test accuracy.
Acta Obstet Gynecol Scand.2010; 89(11):
1374–1384.
13.
LucianoD.E., ExacoustosC., AlbrechtL.Three-dimensional ultrasound in diagnosis of adenomyosis:
histologic correlation with ultrasound targeted biopsies of the
uterus. J Minim Invasive Gynecol.2013; 20(6):
803–810.
14.
VercelliniP., ConsonniD., DridiD., BraccoB., FrattaruoloM.P., SomiglianaE.Uterine adenomyosis and in vitro fertilization outcome: a
systematic review and meta-analysis. Hum
Reprod.2014; 29(5):
964–977.
15.
BrosensJ.J., BarkerF.G., de SouzaN.M.Myometrial zonal differentiation and uterine junctional zone
hyperplasia in the nonpregnant uterus. Hum Reprod
Update.1998; 4(5):
496–502.
16.
AscherS.M., ArnoldL.L., PattR.H.Adenomyosis: prospective comparison of MR imaging and
transvaginal sonography. Radiology.1994; 190(3):
803–806.
17.
AtriM., ReinholdC., MehioA.R., ChapmanW.B., BretP.M.Adenomyosis: US features with histologic correlation in an
in-vitro study. Radiology.2000; 215(3):
783–790.
18.
FedeleL., BianchiS., DortaM., ArcainiL., ZanottiF., CarinelliS.Transvaginal ultrasonography in the diagnosis of diffuse
adenomyosis. Fertil Steril.1992; 58(1):
94–97.
19.
HiraiM., ShibataK., SagaiH., SekiyaS., GoldbergB.B.Transvaginal pulsed and color Doppler sonography for the
evaluation of adenomyosis. J Ultrasound
Med.1995; 14(7):
529–532.
20.
DevliegerR., DHoogheT., TimmermanD.Uterine adenomyosis in the infertility clinic.
Hum Reprod Update.2003; 9(2):
139–147.
21.
DueholmM.Transvaginal ultrasound for diagnosis of adenomyosis: a
review. Best Pract Res Clin Obstet
Gynaecol.2006; 20(4):
569–582.
22.
ReinholdC., AtriM., MehioA., ZakarianR., AldisA.E., BretP.M.Diffuse uterine adenomyosis: morphologic criteria and diagnostic
accuracy of endovaginal sonography.
Radiology.1995; 197(3):
609–614.
23.
NaftalinJ., HooW., PatemanK., MavrelosD., HollandT., JurkovicD.How common is adenomyosis? A prospective study of prevalence
using transvaginal ultrasound in a gynaecology clinic.
Hum Reprod.2012; 27(12):
3432–3439.
24.
ExacoustosC., BrienzaL., Di GiovanniA.Adenomyosis: three-dimensional sonographic findings of the
junctional zone and correlation with histology.
Ultrasound Obstet Gynecol.2011; 37(4):
471–479.
25.
ExacoustosC., LucianoD., CorbettB.The uterine junctional zone: a 3-dimensional ultrasound study of
patients with endometriosis. Am J Obstet
Gynecol2013; 209(3):
248.e1–7.
26.
KepkepK., TuncayY.A., GöynümerG., TutalE.Transvaginal sonography in the diagnosis of adenomyosis: which
findings are most accurate?Ultrasound Obstet Gynecol.2007; 30(3):
341–345.
27.
Van den BoschT., DueholmM., LeoneF.P.Terms, definitions and measurements to describe sonographic
features of myometrium and uterine masses: a consensus opinion from the
Morphological Uterus Sonographic Assessment (MUSA) group.
Ultrasound Obstet Gynecol.2015; 46(3):
284–298.
28.
BazotM., CortezA., DaraiE.Ultrasonography compared with magnetic resonance imaging for the
diagnosis of adenomyosis: correlation with histopathology.
Hum Reprod.2001; 16(11):
2427–2433.
29.
KunzG., BeilD., HuppertP., NoeM., KisslerS., LeyendeckerG.Adenomyosis in endometriosisprevalence and impact on fertility.
Evidence from magnetic resonance imaging. Hum
Reprod.2005; 20(8):
2309–2316.
30.
Di DonatoN., SeracchioliR.How to evaluate adenomyosis in patients affected by
endometriosis?Minim Invasive Surg.2014; 2014:
507230.
31.
LeyendeckerG.,
BilgicyildirimA., InackerM.Adenomyosis and endometriosis. Re-visiting their association and
further insights into the mechanisms of auto-traumatisation. An MRI
study. Arch Gynecol Obstet.2015; 291(4):
917–932.
32.
Martfnez-ConejeroJ.A., MorganM., MontesinosM.Adenomyosis does not affect implantation, but is associated with
miscarriage in patients undergoing oocyte donation.
Fertil Steril.2011; 96(4):
943–950.
33.
BrosensI., PijnenborgR., BenagianoG.Defective myometrial spiral artery remodelling as a cause of
major obstetrical syndromes in endometriosis and
adenomyosis. Placenta.2013; 34(2):
100–105.
34.
BrosensI., PijnenborgR., VercruysseL., RomeroR.The Great Obstetrical Syndromes are associated with disorders of
deep placentation. Am J Obstet Gynecol.2011; 204(3):
193–201.
35.
MochimaruA., AokiS., ObaM.S., KurasawaK., TakahashiT., HiraharaF.Adverse pregnancy outcomes associated with adenomyosis with
uterine enlargement. J Obstet Gynaecol Res.2014; 3:
1–5.
36.
VannucciniS., CliftonV.L., FraserI.S.Infertility and reproductive disorders: impact of hormonal and
inflammatory mechanisms on pregnancy outcome. Hum
Reprod Update.2016; 22(1):
104–115.
37.
MaubonA., FauryA., KapellaM., PouquetM., PiverP.Uterine junctional zone at magnetic resonance imaging: a
predictor of in vitro fertilization implantation failure.
J Obstet Gynaecol Res.2010; 36(3):
611–618.
38.
ThalluriV., TremellenK.P.Ultrasound diagnosed adenomyosis has a negative impact on
successful implantation following GnRH antagonist IVF
treatment. Hum Reprod.2012; 27(12):
3487–3492.
39.
BenagliaL., CardellicchioL., LeonardiM.Asymptomatic adenomyosis and embryo implantation in IVF
cycles. Reprod Biomed Online.2014; 29(5):
606–611.
