Adenomyosis in Pregnancy: Diagnostic Pearls and Pitfalls

Kyle Jensen, Chelsea Pyle, Bryan R. Foster, Roya Sohaey, Karen Y. Oh
Radiographics : a review publication of the Radiological Society of North America, Inc · 2021 · vol. 41(3) , pp. 929–944 · doi:10.1148/rg.2021200120 · PMID:33769889 · W3138073193
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This review details the imaging characteristics of adenomyosis in pregnancy, highlighting how its appearance changes and mimics other conditions, impacting diagnosis and pregnancy outcomes.

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Abstract

Adenomyosis is a common benign uterine disorder in which ectopic endometrial glands extend into the myometrium. Adenomyosis is increasingly diagnosed in young women, affecting 20%–35% of women of reproductive age. Features of adenomyosis can be seen with either US or MRI, especially with newer imaging technology. With advances in reproductive endocrinology as well as a trend toward later maternal age, adenomyosis is increasingly noted during pregnancy, often while performing imaging for other reasons. Hormonal changes during pregnancy alter the appearance of adenomyosis, which includes diffuse, focal, and cystic adenomyosis. Recognizing these imaging changes in pregnancy proves essential for accurately diagnosing adenomyosis as a benign condition, as it mimics serious placental and myometrial abnormalities. Using a lower-frequency US transducer or MRI can be helpful in distinguishing among these entities. Describing the location of adenomyosis in relationship to the site of placentation is also important. Diagnosing adenomyosis is crucial because it can be associated with poor pregnancy outcomes, including spontaneous abortion, preterm birth, and fetal growth restriction. Adenomyosis is also a risk factor for preeclampsia. Intramural ectopic pregnancy is a rare but serious condition that can mimic cystic adenomyosis, and comparison with prepregnancy images can help differentiate the two conditions. The authors review the unique imaging characteristics of adenomyosis in pregnancy, focusing on accurate diagnosis of an underrecognized benign condition that can mimic myometrial and placental pathologic conditions. ©RSNA, 2021

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Condition tags

adenomyosis

MeSH descriptors

Adenomyosis Adenomyosis Premature Birth Uterine Diseases Uterine Diseases Female Humans Infant, Newborn Placenta Pregnancy Pregnancy Outcome

Citation neighborhood

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.

References (38)

Cited by (3)

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