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Re: adenomyosis diagnosisFrom: art fougner, md (evsono@pipeline.com)Mon Oct 20 12:25:51 1997
At Mon, 20 Oct 1997, Geffrey Klein wrote: > >>MRI is THE noninvasive diagnostic modality of choice to rule in or out >>adenomyosis. > >Seems like an expensive test that will not alter management in this >case. What is the sensitivity and specificity of MRI in diagnosing >adenomyosis? If you have a reference(s), I would like to read the >article(s). >though... > >Geff >> here you go :) Article Title: Magnetic resonance imaging for diagnosing adenomyomata. Article Source: J Am Assoc Gynecol Laparosc 1996 Feb;3(2):245-50 Author(s): Phillips DR; Nathanson HG; Milim SJ; Haselkorn JS Abstract: STUDY OBJECTIVES: To evaluate the accuracy of magnetic resonance imaging (MRI) for diagnosing nodular adenomyosis by percutaneous myometrial biopsies. DESIGN: Prospective observational study. SETTING: Gynecology department of community hospitals. PATIENTS: Twenty women with severe dysmenorrhea, chronic menorrhagia, and an MRI diagnosis of adenomyomata. INTERVENTIONS: Several laparoscopically guided, percutaneous myometrial biopsy specimens were taken in an attempt to confirm histologically an MRI diagnosis of adenomyoma; and resectoscopic endomyometrial biopsy specimens were taken in an attempt to confirm an MRI diagnosis of adenomyosis. MEASUREMENTS AND MAIN RESULTS: Eighteen (90%) of the 20 women had an MRI diagnosis of adenomyosis histologically confirmed by myometrial biopsy. The remaining two (20.0%) had an MRI diagnosis of adenomyosis histologically confirmed by endomyometrial biopsy. CONCLUSIONS: An MRl diagnosis of adenomyoma was confirmed by transabdominal uterine biopsy in most patients. These results, when combined with those obtained by resectoscopic endomyometrial biopsy, established a diagnosis of adenomyosis in all patients. Author's Address: Department of Obstetrics and Gynecology, South Nassau Communities Hospital, Oceanside, New York, USA. Article Title: The nonsurgical diagnosis of adenomyosis. Article Source: Obstet Gynecol 1995 Sep;86(3):461-5 Author(s): Arnold LL; Ascher SM; Schruefer JJ; Simon JA Abstract: OBJECTIVE: To survey the nonsurgical diagnostic techniques for distinguishing adenomyosis, and to determine whether one technique offers diagnostic advantages. DATA SOURCES: We conducted a thorough search of the MEDLINE data base and identified English-language papers on adenomyosis published during the last 28 years. Reference lists of retrieved articles were also examined for additional source documents. METHODS OF STUDY SELECTION: We reviewed 238 articles. Papers on nonsurgical diagnostic techniques published in peer-reviewed journals were selected for inclusion. DATA EXTRACTION AND SYNTHESIS: We determined nonsurgical diagnostic techniques for distinguishing adenomyosis to be hysterosalpingography, abdominal ultrasound, transvaginal sonography, and magnetic resonance imaging (MRI). Studies were divided into these four categories, reviewed, and summarized accordingly. Recent reports suggest that noninvasive modalities, eg, transvaginal sonography and MRI, have, made possible the nonsurgical diagnosis of adenomyosis. CONCLUSION: Because of its widespread availability and patient tolerance, transvaginal sonography remains the primary screening modality for imaging the female pelvis. However, for cases in which sonography cannot detect adenomyosis, MRI provides a viable alternative and should be the definitive diagnostic modality of choice. Author's Address: Department of Obstetrics and Gynecology, Georgetown University Medical Center, Washington, DC, USA. sorry about the formatting but i hope this is useful :) art
-- art fougner, md SonoScan/Genetic Sciences forest hills, ny evsono@pipeline.com
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