Diagnosis of adenomyosis: a review.
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This review analyzes preoperative diagnostic methods for adenomyosis, finding transvaginal sonography suboptimal, magnetic resonance imaging superior for both diffuse and focal types, computed tomography poor, and myometrial biopsy useful but not routinely recommended.
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Abstract
This article reviews the various preoperative diagnostic methods for uterine adenomyosis. MEDLINE and PubMed were searched using the keywords adenomyosis and adenomyosis diagnosis. Reviews, case-controlled studies and reports published from 1949 through March 2005 and written, or at least abstracted, in English were analyzed. Transvaginal sonography is superior to the transabdominal route, but its diagnostic sensitivity is still suboptimal, ranging from 50% to 87%. Magnetic resonance imaging is most effective for both diffuse and focal adenomyosis, with sensitivity and specificity that are comparable to or even better than those of sonography as it depicts contrasts between low-intensity lesions and surrounding tissue. Computed tomography has poor diagnostic value due to similar images portrayed by foci and normal myometrium. Myometrial biopsy of the posterior uterine wall, as pursued by some authorities in recent years, is superior to sonography, but its routine use is not recommended. Although various methods were added to the clinician's armamentarium over the last 2 decades, the preoperative diagnosis of adenomyosis remains challenging.
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- Estrogen 17β‑estradiol accelerates the proliferation of uterine junctional zone smooth muscle cells via the let‑7a/Lin28B axis in adenomyosis 2021
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- Short-term results of magnetic resonance imaging-guided focused ultrasound surgery for patients with adenomyosis: symptomatic relief and pain reduction 2010
- The adenomyosis impact on infertility 2009
- Diagnostic accuracy of transvaginal sonography for the diagnosis of adenomyosis: systematic review and metaanalysis 2009
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