Noninvasive Diagnosis of Adenomyosis: Ultrasonography

Adenomyosis is a common gynecologic disease characterized by the invasion of endometrial glands and stroma into the myometrium and is associated with smooth muscle hyperplasia and fibrosis. There are typical 2D sonographic features that are correlated to adenomyosis; some are more specific signs, like intramyometrial cystic and hyperechoic areas and the junctional zone (JZ) bud and lines. It is possible to visualize more clearly the JZ with some post-processing using coronal section of the uterus obtained with 3D TVS acquiring a higher diagnostic accuracy. In the presence of these 2D and 3D TVS features for adenomyosis, the disease showed high anatomical-histological correlation. As histology, TVS findings are able to identify different types, infiltration depth, locations, and sizes of the disease. The types of adenomyosis can be defined as diffuse, focal, and adenomyoma according to the TVS characteristics. Adenomyosis may involve one or more of the uterine layers. The depth of myometrial infiltration is also variable, from cases limited to the more inner myometrium to those involving the whole myometrial thickness. Diffuse and focal adenomyosis therefore can be subsequently divided for the outer myometrium and for the inner myometrium or JZ. There are different attempts to describe by TVS the extension and the severity of the disease inside the uterus based on a number of features, on the percentage of the affected myometrium compared to the whole uterus, and on a TVS classification with score system that assesses the extension of each type of adenomyotic lesion (diffuse, focal, adenomyoma) in the external myometrium and in the JZ and is divided into four grades according to different measurements. The TVS assessment of type and extension of the disease may be helpful in selecting and evaluating the effectiveness of medical and surgical management, as well as the possible relationship between type and extension of adenomyosis and symptoms. Access this chapter Tax calculation will be finalised at checkout Purchases are for personal use only Similar content being viewed by others

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Author information Authors and Affiliations Corresponding author Editor information Editors and Affiliations Rights and permissions Copyright information © 2022 The Author(s), under exclusive license to Springer Nature Switzerland AG About this chapter Cite this chapter Exacoustos, C. (2022). Noninvasive Diagnosis of Adenomyosis: Ultrasonography. In: Oral, E. (eds) Endometriosis and Adenomyosis. Springer, Cham. https://doi.org/10.1007/978-3-030-97236-3_33 Download citation DOI: https://doi.org/10.1007/978-3-030-97236-3_33 Published: Publisher Name: Springer, Cham Print ISBN: 978-3-030-97235-6 Online ISBN: 978-3-030-97236-3 eBook Packages: MedicineMedicine (R0)