Preoperative and Postoperative Clinical and Transvaginal Ultrasound Findings of Adenomyosis in Patients With Deep Infiltrating Endometriosis

Abstract

Deep infiltrating endometriosis is frequently associated with adenomyosis, significantly affecting pre- and postoperative symptoms and thus influencing the follow-up management.

Transvaginal sonographic features of diffuse adenomyosis in 18–30‐year‐old nulligravid women without endometriosis: association with symptoms

“…Recently, adenomyosis has been included in the International Federation of Gynecology and Obstetrics classification system (PALM‐COEIN) for causes of abnormal uterine bleeding in women of reproductive age, which states that, even if the role of adenomyosis in the genesis of abnormal uterine bleeding is extremely controversial, the disorder represents an important cause of abnormal blood loss. However, because dysmenorrhea and heavy bleeding symptoms are commonly present in other gynecological disorders, it is worth bearing in mind that endometriosis or uterine fibroids coexist with adenomyosis in premenopausal women.…”

Influence of adenomyosis on pregnancy and perinatal outcomes in women with endometriosis

“…Standardized ultrasound criteria were used for the diagnoses of DIE 24 and endometriomas 25 . The ultrasonographic diagnosis of adenomyosis was made if two or more of the following features were present: asymmetrical myometrial thickening, myometrial cysts, linear striations, hyperechoic islands or an irregular and thickened endometrial-myometrial junctional zone on either two-or three-dimensional imaging 26,27 . On ultrasonography, focal adenomyosis was defined as the presence of adenomyosis-related lesions in only one part of the myometrium, while diffuse adenomyosis was defined as the presence of ill-defined lesions in more than one site within the uterine wall, more often being dispersed within the myometrium rather than forming a confined lesion 28 .…”

Imaging for the evaluation of endometriosis and adenomyosis

“…Considering the hypothesis that adenomyosis is more likely to be caused by 'invasion' of endometrial tissue across the junctional zone and into the myometrium, three-dimensional transvaginal sonography evaluation of junctional zone could probably be able to detect initial adenomyosis. It has been observed that pelvic endometriosis, especially in severe stages, is also strongly associated with junctional zone thickening and adenomyosis [83,84,88,94]. The junctional zone, if altered, is correlated to adenomyosis, and seems to be involved in the process that determines pelvic endometriosis [73,76,81,83,84].…”