Adenomyosis and Ultrasound: The Role of Ultrasound and Its Impact on Understanding the Disease
Transvaginal sonography has varying diagnostic accuracy for adenomyosis, with 3D ultrasound potentially being more accurate than 2D, and its findings correlate with deep infiltrating endometriosis.
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This paper reviews diagnostic performance of ultrasound for adenomyosis, focusing on transvaginal sonography approaches (2D-TVS and three-dimensional TVS evaluating the uterine junctional zone) in terms of sensitivity, specificity, and accuracy, with discussion of how accuracy varies by disease type (diffuse vs focal) and by confounding factors such as coexistent fibroids. It reports that 3D-TVS appears more accurate than conventional 2D-TVS for detecting adenomyosis, and notes a strong association between deep infiltrating endometriosis and ultrasound features of adenomyosis. A key limitation emphasized is that ultrasound performance is poorer for focal adenomyosis and when fibroids coexist. Relevance to endometriosis: it explicitly describes a strong association between deep infiltrating endometriosis and 2D-TVS/3D-TVS features of adenomyosis, though the paper’s main focus is ultrasound-based diagnosis and imaging interpretation of adenomyosis.
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