Background: The presence of ectopic endometrial duct and stroma in the myometrium is the defining feature of adenomyosis, a benign condition. It has historically been linked to multiparity in females aged > 40 who have experienced menorrhagia. The aim was to detect the role of Complex ultrasound and power doppler indices in Correlation with histopathology to differentiate adenomyosis and fibroid uterus.
Methods: This prospective clinical cohort study was carried out on 102 cases scheduled for hysterectomy (abdominal, laparoscopic, or vaginal) as a result of uterine masses (fibroids or adenomyosis). Transabdominal and Transvaginal ultrasound and uterine artery Doppler was performed for all cases. Ultrasound examination was performed using GE Voluson p8 with patients in supine position.
Results: Fibroid lesions were significantly larger in size and volume than adenomyosis. Vascular patterns differed significantly, with adenomyosis showing predominantly central vascularity and fibroids mainly peripheral vascularity. VI and VFI were significantly elevated in adenomyosis, and all uterine artery Doppler indices (PI and RI on both sides) were elevated in the adenomyosis cases (p < 0.001). Histopathology confirmed 45 cases (44.1%) of adenomyosis and 57 cases (55.9%) of fibroid uterus. VI and right RI demonstrated perfect diagnostic performance (AUC = 1.000) with 100% sensitivity and specificity, while VFI, PI (right and left), and left RI showed excellent discriminatory ability. In contrast, FI showed poor diagnostic accuracy (AUC = 0.567) and was statistically insignificant (p = 0.246).
Conclusions: Combined ultrasound and power Doppler assessment provides useful diagnostic differentiation between adenomyosis and uterine fibroids.