OP15.03: Adenomyosis ultrasound findings in patients with previously know endometriosis

The aim of this study was to describe the adenomyosis ultrasound findings and its relation with different locations of endometriosis in patients with previously known endometriosis. Patients with previously know endometriosis and followed in a tertiary university hospital were included in the study from January 2013 to June 2014. A transvaginal ultrasound (TVUS) was performed by an expert sonographer (Voluson V730Expert, GE) and ultrasound findings regarding endometriosis (ovarian endometriosis, tube affection and anterior and posterior deep infiltrating endometriosis) and adenomyosis were considered. Ultrasound adenomyosis criteria were: myometrial heterogeneity, asymmetric walls (>50% asymmetry), presence of myometrial cysts, echogenic linear striations, focal adenomyosis and infiltration of junctional zone. We considered severe adenomyosis where >2 ultrasound criteria were observed and mild adenomyosis where patients presented ≤2 criteria. Patients were divided in two groups according to adenomyosis grade (severe or mild). Ultrasounds of 166 patients with endometriosis were analysed. 101 patients presented ultrasound criteria of adenomyosis (60.8%), 65.3% of them severe. No statistical differences were found when comparing both groups regarding age, parity, BMI and symptoms. Patients with severe adenomyosis presented more frequently retrouterine and rectosigmoid deep infiltrating endometriosis, as well as kissing ovaries, when they were compared with mild adenomyosis group (p < 0.024, p < 0.021 respectively). However, the presence of endometrioma, tube affection, bladder endometriosis, rectovaginal wall endometriosis and uterosaccral ligament endometriosis showed no statistical differences between groups. In patients with previously known endometriosis, severe adenomyosis is associated with endometriosic retrouterine blockage.