Uterine involvement by endometriosis: Sonographic features from elusive findings to apparent adenomyosis

Safak Olgan, Şafak Olgan, Enver Kerem Dirican, Arif Can Ozsipahi, Ozsipahi AC, Mehmet Sakıncı, Mehmet Sakinci, Sakinci M
European journal of obstetrics, gynecology, and reproductive biology · 2021 · vol. 262 , pp. 93–98 · doi:10.1016/j.ejogrb.2021.05.013 · PMID:34000473 · W3163747401
Observational OA: closed CC0 ⤵ 5 in-corpus citations
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This paper describes sonographic features that can help identify uterine involvement by endometriosis, distinguishing it from apparent adenomyosis.

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Abstract

OBJECTIVE: The primary aim of this study is to investigate whether there are any minor sonographic uterine findings, not typical for adenomyosis, in endometriosis patients. The secondary objective is to determine the prevalence of sonographic features of adenomyosis in an infertile population with endometriosis. STUDY DESIGN: The investigation was of 291 infertile women with endometriosis, either manifesting endometrioma (OMA) or diagnosed through laparoscopy, who were investigated for two-dimensional transvaginal sonographic (2D-TVS) features of adenomyosis. These patients were grouped as either having endometriosis with adenomyosis (EwA,n = 121) or without adenomyosis (EwoA, n = 170). Additionally, patients without both endometriosis and 2D-TVS features of adenomyosis constituted the control group (n = 170). RESULTS: At least one 2D-TVS feature of adenomyosis was detected in 41.6 % (n = 121) of women with endometriosis. Asymmetrical myometrial thickening of uterine walls (57.9 %), hyperechogenic islands (47.1 %), and fan-shaped shadowing (46.9 %) were relatively more prevalent 2D-TVS findings among EwA patients. Multiple OMA (p = 0.038), OMA ≥ 4 cm (p = 0.034), and total OMA volumes were found to be higher (p = 0.004) in the EwA group. Additionally, uterine volumes were found to be 96.7 cm3, 73.0 cm3, and 64.2 cm3 in the EwA, EwoA, and control groups, respectively (EwA vs EwoA, p < 0.001; EwoA vs control, p <0.001). Multivariate linear regression analysis revealed that the presence of endometriosis was independently associated with an increase in uterine volume (β = 0.243, p < 0.001). CONCLUSION: A stepwise and statistically significant volume increase from the control group to the EwoA and then to the EwA group may reflect a spectrum of uterine involvement in endometriosis. This might indicate that many uterine endometriosis cases are still hidden from view, possibly demonstrating an "iceberg phenomenon".

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Condition tags

endometriosisadenomyosis

MeSH descriptors

Adenomyosis Adenomyosis Endometriosis Endometriosis Infertility, Female Infertility, Female Female Female Humans Humans Ultrasonography Ultrasonography

Citation neighborhood (2-hop)

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. Outer rings show 2-hop neighbours — papers reached through the immediate citers/citees. [ collapse to 1-hop ]

References (27)

Cited by (5)

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License: CC0 · commercial use OK