Adenomyosis by myometrial Invasion of endometriosis: Comparison with typical adenomyosis

Sung Kyoung Moon
2010 · doi:10.1594/ecr2010/c-1294 · W2546631936
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This study compared adenomyosis resulting from myometrial invasion of endometriosis to typical adenomyosis to identify distinguishing features.

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This study compared MRI characteristics of uterine adenomyosis caused by myometrial invasion of endometriosis versus typical uterine adenomyosis in 59 patients (ages 25–52) diagnosed with both conditions on MRI between 2007 and 2009. MRI-based evaluation assessed adenomyosis location (inner, outer, diffuse) and related endometriosis features, including whether endometriosis was separated from or abutting adenomyosis, along with adhesions between the uterus and endometriosis and between endometriosis and adjacent organs; the paper’s explicit limitation is that it is a short, retrospective inclusion window and uses MRI diagnosis rather than histologic confirmation for all cases. The results showed adenomyosis was predominantly outer (31 cases), and among outer cases most demonstrated adhesion between the uterus and endometriosis, with many also involving bowel, while endometriosis was more often abutting adenomyosis (41 cases) than separated (18). This paper is centrally about endometriosis-driven adenomyosis — it specifically compares MRI features of adenomyosis by myometrial invasion of endometriosis with typical adenomyosis.

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Abstract

Poster: ECR 2010 / C-1294 / Adenomyosis by myometrial Invasion of endometriosis: Comparison with typical adenomyosis by: K. Moon, H. K. Lim, J. Y. Cho, S. H. Kim; Seoul/KR
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Keywords

Genital / Reproductive system female, Obstetrics (Pregnancy / birth / postnatal period), Pelvis Authors: S. K. Moon, H. K. Lim, J. Y. Cho, S. H. Kim; Seoul/KR DOI: 10.1594/ecr2010/C-1294 Purpose The purposes of this study were to compare the MRI features of uterine adenomyosis by myometrial invasion of endometriosis and the typical uterine adenomyosis.**AdenomyosisNonneoplastic condition, characterized by benign invasion of ectopic endometrium into the myometrium with hyperplasia of adjacent smooth muscle.**Diagnosis of adenomyosisMRI : highly accurate noninvasive modality - high sensitivity (78%–88%) and specificity (67%–93%), - DDx of adenomyosis from other gynecologic disordersBiopsy or surgery**EndometriosisThe presence of functional endometrial glands and stroma outside the uterine cavityIn older literature, endometriosis was further classified asendometriosis interna :...

Methods

and Materials Materials*PatientsInclusion criteria - Diagnosed as adenomyosis and endometriosis on MR - 2007.3 ~ 2009. 2Exclusion criteria - s/p hysterectomy before MRI exam→59 patients (25-52 years, mean 38.7 years) were included in this study.Methods*Evaluation of adenomyosisLocation of adenomyosis in the uterus - inner, outer, and diffuse typeLocation of endometriosis related with adenomyosis - separated, abuttingAdhesion between uterus and endometriosis, and between endometriosis and surrounding other organsSize and internal feature of adenomyosis and endometriosis

Results

* Location of adenomyosis in the uterusInner : 3 casesOuter : 31 casesDiffuse : 25 casesAmong 31 outer cases, 29 cases showed adhesion between uterus and endometriosis, and 17 cases showed adhesion with bowel. The rest two cases with smooth margin of the serosal surface showed no significant adhesion with adjacent other structures.* Location of endometriosis related with adenomyosis Separated from adenomyosis : 18 casesAbutting adenomyosis : 41 casesWe categorized adenomyosis into two groups - adneomyosis by invasion of endometriosis and adenomyosis with coincided endometriosis.Twenty-nine...

Conclusion

Invasion of endometriosis may cause serosal sided adenomyosis and usually shows adhesion between uterus, endometriosis and surrounding organs.This information of invasion and adhesion may behelpful to determine the treatment plan of endometriosis.

References

Tamai, K., et al. MR imaging findings of adenomyosis: correlation with histopathologic features and diagnostic pitfalls. Radiographics 2005; 25:21-40.Tamai, K., et al. Spectrum of MR features in adenomyosis. Best Pract Res Clin Obstet Gynaecol 2006;20:583-602.Grasso, RF. et al. Diagnosis of deep infiltrating endometriosis: accuracy of magnetic resonance imaging and transvaginal 3D ultrasonography. Abdom Imaging 2009 Nov 19. [Epub ahead of print]Del Frate, C., et al. Deep retroperitoneal pelvic endometriosis: MR imaging appearance with laparoscopic correlation. Radiographics 2006;26:1705-1718.Zacharia,TT. andO'Neill, MJ. Prevalence and distribution of adnexal findings... Personal Information Moon, Sung Kyoung, MD.Department of Radiology,Seoul National University Hospital, Seoul, KoreaE-mail: [email protected]

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Condition tags

endometriosisadenomyosis

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