Provocări în diagnosticul neinvaziv al adenomiozei

Uterine adenomyosis, characterized by the ectopic presence of endometrial tissue in the myometrium, has a significant impact on the quality of life of reproductive aged women. Therefore, its prompt diagnosis is essential for symptom relief, but it is often established histologically, after hysterectomy. Noninvasive diagnostic methods have started to gain ground recently, but research is still ongoing. Transvaginal ultrasound (TVUS) has proven itself an essential diagnostic tool, but is less accurate than magnetic resonance imaging in differentiating adenomyosis from uterine leiomyoma. In order to increase the accuracy of the method, the combined use of TVUS and elastography has been attempted, with strain elastography showing promising results. Biomarkers such as interleukin 6, tumour antigens, circulating endometrial cells or microRNAs could represent novel diagnostic tools, but still require further validation in larger-based population studies. Conclusions. The diagnosis of adenomyosis is still challenging, with novel imaging and serological methods emerging as future potential noninvasive assets. Further research is necessary to warrant their diagnostic utility, as well as their capacity of distinguishing adenomyosis from other benign uterine pathologies.