{"paper_id":"cf5e155e-ff97-47a7-ae34-8d378acf3257","body_text":"Abstract\nAdenomyosis is a pathological gynaecological condition characterised by benign invasion of the endometrium into the myometrium. It is often misdiagnosed, or is not easily recognised, although it is responsible for disabling symptoms such as menorrhagia, abnormal uterine bleeding, dysmenorrhoea and infertility in premenopausal women. The aim of this pictorial review is to analyse the features of adenomyosis by illustrating the most usual and typical imaging patterns, along with the unusual appearances, seen in a vast array of gynaecological imaging modalities. The different findings of focal and diffuse adenomyosis along with the diagnostic limitations of ultrasound, hysterosalpingography and magnetic resonance imaging are described, as are the pitfalls and differential diagnosis with other pathological conditions that are often misdiagnosed as adenomyosis. The role of the different imaging modalities in planning appropriate treatment and their usefulness in monitoring therapy are also discussed.\nRiassunto\nL’adenomiosi è caratterizzata dall’invasione benigna del miometrio da parte dell’endometrio ed è spesso sottostimata o diagnosticata con ritardo, nonostante sia invalidante in quanto possibile causa di menorragia, metrorragia, dismenorrea ed infertilità. Lo scopo del lavoro è quello di analizzare gli aspetti diagnostici dell’adenomiosi mostrando i quadri più semplici e quelli più rari e difficili da caratterizzare, raccolti in una ampia galleria che prende in esame tutte le più note tecniche di imaging ginecologico. La forma diffusa di adenomiosi e quelle focali saranno analizzate sulla base dei segni di semeiotica elementare. I limiti e possibilità delle varie tecniche di imaging, ecografia, isterosalpingografia e risonanza magnetica, saranno illustrate ponendo anche particolare attenzione alla diagnostica differenziale con le altre forme morbose più facilmente equivocabili. Sarà infine discusso il ruolo delle metodiche di imaging nella pianificazione del tipo di trattamento e nel monitoraggio dell’efficacia terapeutica.\nSimilar content being viewed by others\nReferences/Bibliografia\nBird CC, McElin TW, Manalo Estrella P (1972) The elusive adenomyosis of the uterus revisited. Am J Obstet Gynecol 112:583–593\nBergeron C, Amant F, Ferency A (2006) A pathology and physiopathology of adenomyosis. Best Pract Res Clin Obstet Gynaecol 20:511–521\nSilverberg S, Kurman R (1992) Tumor-like lesions. In: Rosai J (ed) Tumor of the uterine corpus and gestational trophoblastic disease. 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AJR Am J Roentgenol 177:107–110\nManfredi R, Mirk P, Maresca G et al (2004) Local-regional staging of endometrial carcinoma: role of MR imaging in surgical planning. Radiology 231:372–378\nAuthor information\nAuthors and Affiliations\nCorresponding author\nAdditional information\nAn erratum to this article can be found at http://dx.doi.org/10.1007/s11547-011-0726-1\nRights and permissions\nAbout this article\nCite this article\nValentini, A.L., Speca, S., Gui, B. et al. Adenomyosis: from the sign to the diagnosis. Imaging, diagnostic pitfalls and differential diagnosis: a pictorial review. Radiol med 116, 1267–1287 (2011). https://doi.org/10.1007/s11547-011-0714-5\nReceived:\nAccepted:\nPublished:\nIssue date:\nDOI: https://doi.org/10.1007/s11547-011-0714-5","source_license":"public-domain-us","license_restricted":false}