Journal of Shandong University (Health Sciences) ›› 2022, Vol. 60 ›› Issue (7): 56-65.doi: 10.6040/j.issn.1671-7554.0.2022.0214

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Diagnosis of adenomyosis using ultrasound and magnetic resonance imaging

TAO Guowei1, WANG Fang2, DONG Xiangyi1, XU Yaxuan1, ZHAO Linli1, HU Beibei3   

  1. 1. Department of Ultrasound, Qilu Hospital of Shandong University, Jinan 250012, Shandong, China;
    2. Department of Radiology, Qilu Hospital of Shandong University, Jinan 250012, Shandong, China;
    3. Department of Ultrasound, The First Affiliated Hospital of Shandong First Medical University(Shandong Provincial Qianfoshan Hospital), Jinan 250014, Shandong, China
  • Published:2022-07-27

Abstract: With the development of medical imaging technology, the role of ultrasound and magnetic resonance imaging(MRI)in the evaluation of adenomyosis has been increasingly recognized in clinical work. Transvaginal ultrasound(TVUS)remains the first-line diagnostic method for adenomyosis and MRI can serve as a complementary tool. The purpose of this study is to review the imaging-pathological correlation, classification, ultrasonic and MRI features, standardized description of adenomyosis, advances in ultrasound techniques, and classification evaluation of MRI.

Key words: Adenomyosis, Ultrasound, Magnetic resonance imaging, Contrast-enhanced ultrasound, Elastography

CLC Number: 

  • R711.74
[1] Chapron C, Vannuccini S, Santulli P, et al. Diagnosing adenomyosis: an integrated clinical and imaging approach[J]. Hum Reprod Update, 2020, 26(3): 392-411.
[2] Oliva E, Zaloudek CJ, Soslow RA. Mesenchymal tumors of the uterus. In: Kurman RJ, Ellenson LH, Ronnett BM(eds). Blausteins pathology of the female genital tract(Sixth Edition)[M]. New York: Springer Science, 2011: 453-528.
[3] Ferenczy A. Pathophysiology of adenomyosis [J]. Hum Reprod Update, 1998, 4(4): 312-322.
[4] Bazot M, Cortez A, Darai E, et al. Ultrasonography compared with magnetic resonance imaging for the diagnosis of adenomyosis: correlation with histopathology[J]. Hum Reprod, 2001, 16(11): 2427-2433.
[5] Pistofidis G, Makrakis E, Koukoura O, et al. Distinct types of uterine adenomyosis based on laparoscopic and histopathologic criteria[J]. Clin Exp Obstet Gynecol, 2014, 41(2): 113-118.
[6] Brosens I, Gordts S, Habiba M, et al. Uterine cystic adenomyosis: a disease of younger women[J]. J Pediatr Adolesc Gynecol, 2015, 28(6): 420-426.
[7] Benagiano G, Brosens I. History of adenomyosis[J]. Best Pract Res Clin Obstet Gynaecol, 2006, 20(4): 449-463.
[8] Chapron C, Tosti C, Marcellin L, et al. Relationship between the magnetic resonance imaging appearance of adenomyosis and endometriosis phenotypes[J]. Hum Reprod, 2017, 32(7): 1393-1401.
[9] Uduwela AS, Perera MA, Aiqing L, et al. Endometrial-myometrial interface: relationship to adenomyosis and changes in pregnancy[J]. Obstet Gynecol Surv, 2000, 55(6): 390-400.
[10] Hricak H, Alpers C, Crooks LE, et al. Magnetic resonance imaging of the female pelvis: initial experience[J]. AJR Am J Roentgenol, 1983, 141(6): 1119-1128.
[11] Vercellini P, Viganò P, Somigliana E, et al. Adenomyosis: epidemiological factors[J]. Best Pract Res Clin Obstet Gynaecol, 2006, 20(4): 465-477.
[12] Brown HK, Stoll BS, Nicosia SV, et al. Uterine junctional zone: correlation between histologic findings and MR imaging[J]. Radiology, 1991, 179(2): 409-413.
[13] Scoutt LM, Flynn SD, Luthringer DJ, et al. Junctional zone of the uterus: correlation of MR imaging and histologic examination of hysterectomy specimens[J]. Radiology, 1991, 179(2): 403-407.
[14] Novellas S, Chassang M, Delotte J, et al. MRI characteristics of the uterine junctional zone: from normal to the diagnosis of adenomyosis[J]. AJR Am J Roentgenol, 2011, 196(5): 1206-1213.
[15] Rasmussen CK, Glavind J, Madsen LD, et al. Repeatability of junctional zone measurements using 3-dimensional transvaginal sonography in healthy fertile women[J]. J Ultrasound Med, 2016, 35(7): 1497-1508.
[16] Parrott E, Butterworth M, Green A, et al. Adenomyosis—a result of disordered stromal differentiation[J]. Am J Pathol, 2001, 159(2): 623-630.
[17] Bergeron C, Amant F, Ferenczy A. Pathology and physiopathology of adenomyosis[J]. Best Pract Res Clin Obstet Gynaecol, 2006, 20(4): 511-521.
[18] Exacoustos C, Brienza L, Di Giovanni A, et al. Adenomyosis: three-dimensional sonographic findings of the junctional zone and correlation with histology[J]. Ultrasound Obstet Gynecol, 2011, 37(4): 471-479.
[19] Hamimi A. What are the most reliable signs for the radiologic diagnosis of uterine adenomyosis? An ultrasound and MRI prospective[J]. Egypt J Radiol Nucl Med, 2015, 46(4): 1349-1355.
[20] Sofic A, Husic-Selimovic A, Carovac A, et al. The significance of MRI evaluation of the uterine junctional zone in the early diagnosis of adenomyosis[J]. Acta Inform Med, 2016, 24(2): 103-106.
[21] Rasmussen CK, Hansen ES, Dueholm M. Two- and three-dimensional ultrasonographic features related to histopathology of the uterine endometrial-myometrial junctional zone[J]. Acta Obstet Gynecol Scand, 2019, 98(2): 205-214.
[22] Rasmussen CK, Hansen ES, Ernst E, et al. Two- and three-dimensional transvaginal ultrasonography for diagnosis of adenomyosis of the inner myometrium[J]. Reprod Biomed Online, 2019, 38(5): 750-760.
[23] Dueholm M, Lundorf E, Hansen ES, et al. Magnetic resonance imaging and transvaginal ultrasonography for the diagnosis of adenomyosis[J]. Fertil Steril, 2001, 76(3): 588-594.
[24] Luciano DE, Exacoustos C, Albrecht L, et al. Three-dimensional ultrasound in diagnosis of adenomyosis: histologic correlation with ultrasound targeted biopsies of the uterus[J]. J Minim Invasive Gynecol, 2013, 20(6): 803-810.
[25] Schindl M, Birner P, Obermair A, et al. Increased microvessel density in adenomyosis uteri[J]. Fertil Steril, 2001, 75(1): 131-135.
[26] Goteri G, Lucarini G, Montik N, et al. Expression of vascular endothelial growth factor(VEGF), hypoxia inducible factor-1alpha(HIF-1alpha), and microvessel density in endometrial tissue in women with adenomyosis[J]. Int J Gynecol Pathol, 2009, 28(2): 157-163.
[27] Tahlan A, Nanda A, Mohan H. Uterine adenomyoma: a clinicopathologic review of 26 cases and a review of the literature[J]. Int J Gynecol Pathol, 2006, 25(4): 361-365.
[28] Van den Bosch T, de Bruijn AM, de Leeuw RA, et al. Sonographic classification and reporting system for diagnosing adenomyosis[J]. Ultrasound Obstet Gynecol, 2019, 53(5): 576-582.
[29] 中国医师协会妇产科医师分会子宫内膜异位症专业委员会.子宫腺肌病诊治中国专家共识[J]. 中华妇产科杂志, 2020, 55(6): 376-383.
[30] Andres MP, Borrelli GM, Ribeiro J, et al. Transvaginal ultrasound for the diagnosis of adenomyosis: systematic review and Meta-analysis[J]. J Minim Invasive Gynecol, 2018, 25(2): 257-264.
[31] Reinhold C, Tafazoli F, Mehio A, et al. Uterine adenomyosis: endovaginal US and MR imaging features with histopathologic correlation[J]. Radiographics, 1999, 19 Spec No: S147-S160.
[32] Van den Bosch T, Dueholm M, Leone FP, et al. Terms, definitions and measurements to describe sonographic features of myometrium and uterine masses: a consensus opinion from the Morphological Uterus Sonographic Assessment(MUSA)group[J]. Ultrasound Obstet Gynecol, 2015, 46(3): 284-298.
[33] Di Donato N, Seracchioli R. How to evaluate adenomyosis in patients affected by endometriosis?[J]. Minim Invasive Surg, 2014, 2014: 507230. doi: 10.1155/2014/507230.
[34] Kepkep K, Tuncay YA, Göynümer G, et al. Transvaginal sonography in the diagnosis of adenomyosis: which findings are most accurate?[J]. Ultrasound Obstet Gynecol, 2007, 30(3): 341-345.
[35] Naftalin J, Hoo W, Nunes N, et al. Association between ultrasound features of adenomyosis and severity of menstrual pain[J]. Ultrasound Obstet Gynecol, 2016, 47(6): 779-783.
[36] Verma SK, Lev-Toaff AS, Baltarowich OH, et al. Adenomyosis: sonohysterography with MRI correlation[J]. AJR Am J Roentgenol, 2009, 192(4): 1112-1116.
[37] Cunningham RK, Horrow MM, Smith RJ, et al. Adenomyosis: a sonographic diagnosis[J]. Radiographics, 2018, 38(5): 1576-1589.
[38] Levy G, Dehaene A, Laurent N, et al. An update on adenomyosis[J]. Diagn Interv Imaging, 2013, 94(1): 3-25.
[39] Xu C, Tang Y, Zhao Y, et al. Use of contrast-enhanced ultrasound in evaluating the efficacy and application value of microwave ablation for adenomyosis[J]. J Cancer Res Ther, 2020, 16(2): 365-371.
[40] 卢峻, 佘志红, 熊奕,等. 子宫肌瘤与子宫腺肌症超声造影强化形式的临床应用[J]. 放射学实践, 2011, 26(8): 890-892. LU Jun, SHE Zhihong, XIONG Yi, et al. Value of contrast-enhanced ultrasound with SonoVue in differentiation between uterine leiomyoma and uterine adenomyosis[J]. Radiologic Practice, 2011, 26(8): 890-892.
[41] Stoelinga B, Juffermans L, Dooper A, et al. Contrast-enhanced ultrasound imaging of uterine disorders: a systematic review[J]. Ultrason Imaging, 2021, 43(5): 239-252.
[42] Stoelinga B, Hehenkamp WJ, Brölmann HA, et al. Real-time elastography for assessment of uterine disorders[J]. Ultrasound Obstet Gynecol, 2014, 43(2): 218-226.
[43] Frank ML, Schäfer SD, Möllers M, et al. Importance of transvaginal elastography in the diagnosis of uterine fibroids and adenomyosis[J]. Ultraschall Med, 2016, 37(4): 373-378.
[44] Stoelinga B, Hehenkamp W, Nieuwenhuis LL, et al. Accuracy and reproducibility of sonoelastography for the assessment of fibroids and adenomyosis, with magnetic resonance imaging as reference standard[J]. Ultrasound Med Biol, 2018, 44(8): 1654-1663.
[45] 刘庆. 实时超声弹性成像技术用于子宫肌瘤、子宫腺肌瘤的鉴别诊断[J]. 影像研究与医学应用, 2019, 3(4): 219-220.
[46] Acar S, Millar E, Mitkova M, et al. Value of ultrasound shear wave elastography in the diagnosis of adenomyosis[J]. Ultrasound, 2016, 24(4): 205-213.
[47] Liu X, Ding D, Ren Y, et al. Transvaginal elastosonography as an imaging technique for diagnosing adenomyosis[J]. Reprod Sci, 2018, 25(4): 498-514.
[48] Bazot M, Dara E. Role of transvaginal sonography and magnetic resonance imaging in the diagnosis of uterine adenomyosis[J]. Fertil Steril, 2018, 109(3): 389-397.
[49] Bazot M, Cortez A, Darai E, et al. Ultrasonography comparedwith magnetic resonance imaging for the diagnosis of adenomyosis: correlation with histopathology [J]. Hum Reprod, 2001, 16(11): 2427-2433.
[50] Hauth EA, Jaeger HJ, Libera H, et al. MR imaging of the uterus and cervix in healthy women: determination of normal values [J]. Eur Radiol, 2007, 17(3): 734-742.
[51] Gordts S, Grimbizis G, Campo R. Symptoms and classification of uterine adenomyosis, including the place of hysteroscopy in diagnosis [J]. Fertil Steril, 2018, 109(3): 380-388.
[52] Champaneria R, Abedin P, Daniels J, et al. Ultrasound scan and magnetic resonance imaging for the diagnosis of adenomyosis: systematic review comparing test accuracy [J]. Acta Obstet Gynecol Scand, 2010, 89(11): 1374-1384.
[53] Kobayashi H, Matsubara S. A classification proposal for adenomyosis based on magnetic resonance imaging [J]. Gynecol Obstet Invest, 2020, 85(2): 118-126.
[54] Gordts S, Brosens JJ, Fusi L, et al. Uterine adenomyosis: a need for uniform terminology and consensus classification [J]. Reprod Biomed Online, 2008, 17(2): 244-248.
[55] Agostinho L, Cruz R, Osório F, et al. MRI for adenomyosis: a pictorial review [J]. Insights Imaging, 2017, 8(6): 549-556.
[56] Chapron C, Fauconnier A, Vieira M, et al. Anatomical distribution of deeply infiltrating endometriosis: surgical implications and proposition for a classification [J]. Hum Reprod, 2003, 18(1): 157-161.
[57] Bazot M, Darai E, Hourani R, et al. Deep pelvice ndometriosis: MR imaging for diagnosis and prediction of extension of disease [J]. Radiology, 2004, 232(2): 379-389.
[58] Kunz G, Beil D, Huppert P, et al. Adenomyosis in endometriosis-prevalence and impact on fertility. Evidence from magnetic resonance imaging [J]. Hum Reprod, 2005, 20(8): 2309-2316.
[59] Naftalin J, Hoo W, Nunes N, et al. Association between ultrasound features of adenomyosis and severity of menstrual pain [J]. Ultrasound Obstet Gynecol, 2016, 47(6): 779-783.
[60] 戴晴,郑宇觐.子宫腺肌病的超声诊断及进展[J].中国实用妇科与产科杂志,2019, 35(5): 501-504. DAI Qing, ZHENG Yujin. Ultrasound diagnosis and progress of adenomyosis [J]. Chinese Journal of Practical Gynecology and Obstetrics, 2019, 35(5): 501-504.
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