Adenomyosis -USG or MRI which is better??

Adenomyosis is defined by the presence of ectopic endometrial glands and stroma within the myometrium. The presence of ectopic endometrial glands and stroma induces a hypertrophic and hyperplastic reaction in the surrounding myometrial tissue.

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• Srimanta Pal Which modality of diagnosis is more helpful?? Is it USG or MRI?? Adenomyosis is a common finding in women of repro-
  ductive age. Surprisingly , Most women with adenomyosis are asymp
  tomatic. When symptomatic, adenomyosis can cause
  pelvic pain and abnormal uterine bleeding. The diagno
  sis of adenomyosis by properly done sonography has been well defined
  and has diagnostic capabilities comparable to MRI. When
  a diagnostic imaging modality is required for suspected
  adenomyosis, sonography should be given first considera
  ion given its efficacy, safety, and lower cost.How accurate is USG to pick up adenomyosis?? A recent meta-analysis on the accuracy of sonography in the diagnosis of adenomyosis showed that it had sensitivity of 82.5% (95% confidence interval, 77.5–87.9) and specificity of 84.6% (79.8–89.8) with a positive likelihood ratio of 4.7 (3.1–7.0) and a negative likelihood ratio of 0.26 (0.18–0.39). What we can image in the USG?? Ans: A globular uterus, cystic spaces, and linear striations are the most specific findings in the diagnosis of adenomyosis 1) Uterine enlargement—Globular uterine enlargement
  that is generally up to 12 cm in uterine length and that
  is not explained by the presence of leiomyomata is a
  characteristic finding. 2. Cystic anechoic spaces or lakes in the myometrium—
  The cystic anechoic spaces within the myometrium
  are variable in size and can occur throughout the my
  ometrium . The cystic changes in the outer
  myometrium may on occasion represent small arcuate
  veins rather than adenomyomas. The application of
  color Doppler imaging at low velocity scales may help
  in this differentiation.
  3. Uterine wall thickening—The uterine wall thicken-
  ing can show anteroposterior asymmetry, especially
  when the disease is focal .
  4. Subendometrial echogenic linear striations—Invasion
  of the endometrial glands into the subendometrial
  tissue induces a hyperplastic reaction, which appears as echogenic linear striations fanning out from the
  endometrial layer
  . Heterogeneous echo texture—there is a lack of homo-
  geneity within the myometrium with evidence of archi-
  tectural disturbance .This finding has
  been shown to be the most predictive of adenomyosis.
  6. Obscure endometrial/myometrial border—Invasion
  of the myometrium by the glands also obscures the
  normally distinct endometrial/myometrial border
  7. Thickening of the transition zone—This zone is a
  layer that appears as a hypoechoic halo surrounding
  the endometrial layer. A thickness of 12 mm or greater
  has been shown to be associated with adenomyosis