Adenomyosis: three‐dimensional sonographic findings of the junctional zone and correlation with histology

Abstract

Objective

The uterine junctional zone: a 3-dimensional ultrasound study of patients with endometriosis

“…In a previous article, we showed that these 3-dimensional ultrasound JZ alterations are associated with adenomyosis. 26 These study results demonstrated an association of uterine adenomyosis and pelvic endometriosis. Structural and functional characteristics of the endometrium and myometrial JZ in women with adenomyosis and endometriosis provide increasing evidence that they frequently are associated; both are characterized by an aberrant function of the JZ and may be an important factor of infertility.…”

“…These sonographic features obtained on 3-dimensional multiplanar view and VCI modality were defined in the following manner 26 : JZmax and JZmin diameter as the greatest and lowest thickness measured of the JZ, on coronal section or longitudinal section at any level of the uterus (fundus, anterior, posterior, and lateral walls); maximal myometrium thickness as the diameter from the basal endometrium to uterine serosa that was measured at the same level of JZmax thickness; alteration of the JZ as distortion and infiltration of the hypoechoic inner myometrium by hyperechoic endometrial tissue or ill-defined JZ 26 (Figures 3 and 4). Three-dimensional ultrasound imaging of a normal uterus in the coronal plane…”

“…8,23,24 It has been shown that 3-dimensional reconstruction of uterine anatomy in the coronal plane provides a new and different view of the JZ. 2,[25][26][27] With 3-dimensional transvaginal sonography (TVS) coronal and multiplanar views of the uterine cavity, it is possible to assess the lateral and fundal aspects of the JZ, which are impossible to see clearly on standard 2-dimensional imaging. We showed in a previous study that 3-dimensional TVS evaluation of JZ is more accurate than conventional 2-dimensional to detect adenomyosis.…”

“…We showed in a previous study that 3-dimensional TVS evaluation of JZ is more accurate than conventional 2-dimensional to detect adenomyosis. 26 The aim of this prospective study was to assess the 3-dimensional TVS detectable uterine morphologic alterations of the JZ in patients affected by pelvic endometriosis that had been diagnosed by laparoscopy and histologic evaluation and to compare these findings with patients without pelvic endometriosis. Furthermore JZ 3-dimensional TVS features were correlated with the laparoscopic stage 28 of pelvic endometriosis.…”

Clinical and ultrasonological features of adenomyosis and its histopathological correlation

“…7 Exacoustos et al reported pain and bleeding as symptoms typical of adenomyosis, but also stated that many women remain asymptomatic. 17 Shestha et al in their study on 78 women found that heavy menstrual bleed was present in 78.2% along with chronic pelvic pain 76.9%. Dysmenorrhoea and dyspareunia was present in 73.1% and 24.4% of subjects respectively.…”