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

Caterina Exacoustos, C. Exacoustós, D. Luciano, Danielle Luciano, Luciano D, Corbett B, Brenda Corbett, B. Corbett, G. De Felice, Giovanna De Felice, De Felice G, Mara Di Feliciantonio, Di Feliciantonio M, Luciano A, Anthony Luciano, Anthony A. Luciano, Errico Zupi
American journal of obstetrics and gynecology · 2013 · vol. 209(3) , pp. 248.e1–248.e7 · doi:10.1016/j.ajog.2013.06.006 · PMID:23770466 · W2048815922
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This 3D ultrasound study characterized the uterine junctional zone in patients with endometriosis, comparing its morphology and vascularization to healthy controls.

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Abstract

ObjectiveThe uterine junctional zone (JZ) alterations are correlated with adenomyosis. An accurate evaluation of the JZ may be obtained by 3-dimensional transvaginal sonography (TVS). The aim of the present prospective study was to assess the value of detectable alterations by 3-dimensional TVS of the JZ in patients with pelvic endometriosis (diagnosed by laparoscopy and histologic condition) and to compare these findings with those of women without pelvic endometriosis.Study designEighty-two patients who were scheduled for laparoscopy had undergone previous surgery and 2- and 3-dimensional TVS. Uterine multiplanar sections that were obtained by 3-dimensional TVS were used to evaluate JZ features. During laparoscopy, an accurate staging of pelvic endometriosis was performed. JZ thickness and JZ alterations were correlated with stage of endometriosis.ResultsOf the 82 patients, 59 patients had endometriosis at laparoscopy and histology. The maximum thickness of JZ in patients with endometriosis was significantly greater than in patients without endometriosis (6.5 ± 1.9 mm vs 4.8 ± 1.0 mm; P < .001). The features of JZ appeared similar at different stages, whereas they are statistically different if correlated with patients without endometriosis.ConclusionJZ thickness and its alterations are different in patients with endometriosis compared with those women without endometriosis and are not correlated with American Society of Reproductive Medicine staging methods. Because these JZ ultrasound features are associated mostly with adenomyosis, a correlation between endometriosis and JZ hyperplasia and adenomyosis could be hypothesized. Noninvasive evaluation of the JZ may be useful in the identification of those women who are affected by endometriosis also in early stage of the disease when there are no other sonographic signs of pelvic endometriosis.

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Condition tags

endometriosis

MeSH descriptors

Endometriosis Uterus Uterus Adenomyosis Adenomyosis Adult Endometriosis Female Humans Prospective Studies Ultrasonography Uterus Young Adult

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Papers in the corpus that this work cites (lower rings, blue) and that cite this one (upper rings, green). Dot size scales with the paper's in-corpus citation count — bigger dot = more influential within the endo/adeno field. Click a dot to open that paper. [ expand to 2 hops ] — adds papers reached through this work's immediate citers/citees. Heavier; up to 60 extra dots.

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