Sonografische Diagnostik am klinischen Fallbeispiel: Anwendung der MUSA-Kriterien bei Adenomyosis uteri und deren Differenzialdiagnosen

In: Geburtshilfe und Frauenheilkunde · 2025 · vol. 85(09) , pp. 914–919 · doi:10.1055/a-2656-9205 · W4413938538
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This paper investigates the utility of the Morphological Uterus Sonographic Assessment (MUSA) criteria for differentiating adenomyosis uteri from differential diagnoses such as uterine hemangiomas and uterine sarcomas.

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The paper presents a clinical case illustrating the application of Morphological Uterus Sonographic Assessment (MUSA) criteria to differentiate adenomyosis uteri from differential diagnoses, specifically uterine hemangiomas and uterine sarcomas. Using the featured case, the authors evaluate whether MUSA-based sonographic assessment enables clear delimitation between these entities. A stated caveat is that the discussion is anchored to a single case example rather than a broader diagnostic study. Relevance to endometriosis: adenomyosis is closely related to endometriosis-spectrum disease in pelvic pathology, and the paper’s focus on standardizing sonographic diagnosis of adenomyosis uteri for differential diagnosis is directly pertinent to endometriosis-related diagnostic workups.

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Abstract

Zur Standardisierung der sonografischen Beurteilung uteriner Läsionen wurden die Morphological Uterus Sonographic Assessment-(MUSA-)Kriterien veröffentlicht. Anhand des im Folgenden vorgestellten Falls gehen die Autoren der Frage nach, ob mittels der MUSA-Kriterien eine klare Abgrenzung zu Differenzialdiagnosen wie uterinen Hämangiomen oder uterinen Sarkomen gelingen kann.
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Subscribe to RSS Please copy the URL and add it into your RSS Feed Reader. https://www.thieme-connect.de/rss/thieme/en/10.1055-s-00000020.xml Geburtshilfe Frauenheilkd 2025; 85(09): 914-919 DOI: 10.1055/a-2656-9205 DOI: 10.1055/a-2656-9205 GebFra Magazin Aktuell diskutiert Sonografische Diagnostik am klinischen Fallbeispiel: Anwendung der MUSA-Kriterien bei Adenomyosis uteri und deren Differenzialdiagnosen Authors Zur Standardisierung der sonografischen Beurteilung uteriner Läsionen wurden die Morphological Uterus Sonographic Assessment-(MUSA-)Kriterien veröffentlicht. Anhand des im Folgenden vorgestellten Falls gehen die Autoren der Frage nach, ob mittels der MUSA-Kriterien eine klare Abgrenzung zu Differenzialdiagnosen wie uterinen Hämangiomen oder uterinen Sarkomen gelingen kann. Publication History Article published online: 02 September 2025 © 2025. Thieme. All rights reserved. Georg Thieme Verlag KG Oswald-Hesse-Straße 50, 70469 Stuttgart, Germany - Literatur - 1 Deutsche Gesellschaft für Gynäkologie und Geburtshilfe, Österreichische Gesellschaft für Gynäkologie und Geburtshilfe, Schweizerische Gesellschaft für Gynäkologie und Geburtshilfe. Diagnostik und Therapie der Endometriose. 2020 Accessed March 30, 2025 at: https://register.awmf.org/assets/guidelines/015-045l_S2k_Diagnostik_Therapie_Endometriose_2020-09.pdf - 2 International Society for the Study of Vascular Anomalies. ISSVA Classification & Glossary for Vascular Anomalies. 2025 Accessed March 30, 2025 at: https://www.issva.org/UserFiles/file/ISSVAUpdatedflowdiagram_03152025_copyright_3.21.25.pdf - 3 Farahani M, Hashemi SA, Goodarzi S. et al. A rare case report of cervical hemangioma and a comprehensive literature review of 137 cases of cervical and uterine hemangiomas. Int J Gynaecol Obstet 2024; 164: 421-435 - 4 Liao Q, Wang J, Han J. Clinical and pathological analysis on 106 cases with uterine sarcoma. Zhonghua Fu Chan Ke Za Zhi 2001; 36: 104-107 - 5 Deutsche Gesellschaft für Gynäkologie und Geburtshilfe, Österreichische Gesellschaft für Gynäkologie und Geburtshilfe, Schweizerische Gesellschaft für Gynäkologie und Geburtshilfe. Uterine Sarkome. 2024 Accessed March 30, 2025 at: https://register.awmf.org/assets/guidelines/015-074l_S2k_Uterine_Sakrome_2024-10.pdf - 6 Van den Bosch T, Dueholm M, Leone FP. et al. Terms, definitions and measurements to describe sonographic features of myometrium and uterine masses: A consensus opinion from the Morphological Uterus Sonographic Assessment (MUSA) group. Ultrasound Obstet Gynecol 2015; 46: 284-298 - 7 Esmer AÇ, Özsürmeli M, Yüksel A. et al. Antenatal sonographic diagnosis of diffuse cavernous hemangioma of the uterus. Marmara Medical Journal 2014; 27: 134-137 - 8 Bauters E, Aertsen M, Froyman W. et al. Uterine hemangioma in pregnancy: A case report and review of the literature. J Gynecol Obstet Hum Reprod 2022; 51: 102401 - 9 Bai XL, Cao X. Postpartum hemorrhage and prolonged hyperfibrinolysis as complications of uterine cavernous hemangioma: a case report and literature review. CEOG 2021; 48: 987-990 - 10 Moradi B, Izadi-Mood N, Chavoshi M. et al. Magnetic resonance imaging features of diffuse cavernous hemangioma of the uterus misdiagnosed as a low grade sarcoma: A case report. I J Radiol 2020; 17: e99416 - 11 Varli G, Kılıçarslan A. Cavernous hemangiomatous polyp of uterus. Hitit Medical Journal 2021; 3: 20-22 - 12 Ludovisi M, Moro F, Pasciuto T. et al. Imaging in gynecological disease (15): Clinical and ultrasound characteristics of uterine sarcoma. Ultrasound Obstet Gynecol 2019; 54: 676-687 - 13 De Bruyn C, Ceusters J, Vanden Brande K. et al. Ultrasound features using MUSA terms and definitions in uterine sarcoma and leiomyoma: cohort study. Ultrasound Obstet Gynecol 2024; 63: 683-690 - 14 Parekh A, Sharma B, Patel K. et al. Cavernous hemangioma of uterus – Report of two cases and review of literature: Cavernous hemangioma of uterus. GAIMS Journal of Medical Sciences 2021; 1: 33-40 - 15 Mastilović K, Rajović J, Zikić Ê. et al. Hemangioma of the uterus. Arch Oncol 2005; 13: 148-149 - 16 Thanner F, Suetterlin M, Kenn W. et al. Pregnancy-associated diffuse cavernous hemangioma of the uterus. Acta obstetricia et gynecologica Scandinavica 2001; 80: 1150-1151 - 17 Weissman A, Talmon R, Jakobi P. Cavernous hemangioma of the uterus in a pregnant woman. Obstet Gynecol 1993; 81: 825-827 - 18 Agarwal M, Agrawal A, Bhadani P. et al. Localized cavernous hemangioma of uterus: a rare cause of abnormal uterine bleeding. J Case Rep 2016; 6: 388-390 - 19 Lotgering FK, Pijpers L, van Eijck J. et al. Pregnancy in a patient with diffuse cavernous hemangioma of the uterus. Am J Obstet Gynecol 1989; 160: 628-630 - 20 Gada RP, Simmons PS, Wilson TO. et al. A hemangioma of the cervix in childhood can be a harbinger of menorrhagia and infertility as an adult. J Pediatr Adolesc Gynecol 2014; 27: e139-e141 - 21 Saeed-Vafa D, Myers E, Huang Y. et al. Localized cavernous hemangioma of the uterus involving adenomyotic foci. J Cancer Res Ther 2011; 7: 69-71 - 22 Park GE, Rha SE, Oh SN. et al. Ultrasonographic findings of low-grade endometrial stromal sarcoma of the uterus with a focus on cystic degeneration. Ultrasonography 2016; 35: 124-230

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Outcome instruments

MUSA

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adenomyosisdie_deep_infiltrating

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