AMEI's Current Trends in Diagnosis & Treatment

Register      Login

VOLUME 4 , ISSUE 2 ( July-December, 2020 ) > List of Articles


Evaluating the Efficacy of Radiological Investigations of Adenomyosis with Clinical Symptomatology

Amanat Sidhu, Sangeeta Pahwa

Citation Information : Sidhu A, Pahwa S. Evaluating the Efficacy of Radiological Investigations of Adenomyosis with Clinical Symptomatology. Curr Trends Diagn Treat 2020; 4 (2):65-68.

DOI: 10.5005/jp-journals-10055-0103

License: CC BY-NC 4.0

Published Online: 01-12-2020

Copyright Statement:  Copyright © 2020; The Author(s).


Introduction: Adenomyosis is a benign gynecological condition that predominantly affects women in the late reproductive age. It is a real challenge in healthcare with prevalence ranging from 5 to 70%. It is characterized by uterine enlargement caused by ectopic rests of the endometrium within the myometrium. It is mainly associated with abnormal menstrual bleeding and severe dysmenorrhea. But now it can be done by advanced imaging modalities like transvaginal ultrasound (USG) and magnetic resonance imaging (MRI). Materials and methods: A prospective longitudinal study was conducted from November 1, 2018 to January 31, 2020 on subjects with complaints of abnormal uterine bleeding and or with dysmenorrhea in the department of obstetrics and gynecology (OBG) of a tertiary care hospital and medical institution. Various medical and surgical treatments were offered on merit depending on age group and clinical symptomatology. The subjects were followed up for a minimum period of six months thereafter. Results: It was found that out of the patients who had visual analog scale (VAS) score less than 7, 22.58% had adenomyosis with normal uterus while 12.90% had bulky uterus with adenomyosis on ultrasound. Of the patients who had VAS score more than or equal to 7, 9.68% had adenomyosis with normal uterus while 54.84% had bulky uterus with adenomyosis. MRI supplemented the ultrasound findings and was found useful in the confirmation of adenomyosis. Conclusion: The clinical diagnosis of adenomyosis has been called enigmatic largely because there are no pathognomonic symptoms of this disease. Ultrasound and MRI are found to be highly useful in supplementing the correct diagnosis of adenomyosis.

  1. Cunningham F, Levono K, Bloom S, et al. Williams gynecology, 2nd edition. New York; McGraw-Hill Education; 2012. p. 259.
  2. Naftalin J, Hoo W, Pateman K, et al. How common is adenomyosis? A prospective study of prevalence using transvaginal ultrasound in a gynaecology clinic. Hum Reprod 2012;27(12):3432–3439. DOI: 10.1093/humrep/des332.
  3. Exacoustos C, Brianza L, Di Giovanni A, et al. Adenomyosis: three-dimensional sonographic findings of the junctional zone and correlation with histology, ultrasound in obstetrics and gynecology. Ultrasound Obstet Gynecol 2011;37(4):471–479. DOI: 10.1002/uog.8900.
  4. Munro MG, Critchley HOD, Broder MS, et al. FIGO classification system (PALM-COEIN) for causes of abnormal uterine bleeding in nongravid women of reproductive age. Int J Gynecol Obstet 2011;113(1):3–13. DOI: 10.1016/j.ijgo.2010.11.011.
  5. Levgur M, Abadi MA, Tucker A. Adenomyosis: symptoms, histology, and pregnancy terminations. Obstet Gynecol 2000;95(5):688–691. DOI: 10.1016/s0029-7844(99)00659-6.
  6. García-Solares J, Donnez J, Donnez O, et al. Pathogenesis of uterine adenomyosis: invagination or metaplasia? Fertil Steril 2018;109(3):371–379. DOI: 10.1016/j.fertnstert.2017.12.030.
  7. Exacoustos C, Morosetti G, Conway F, et al. New sonographic classification of adenomyosis: do type and degree of adenomyosis correlate to severity of symptoms? J Minim Invasive Gynecol 2020;27(6):1308–1315. DOI: 10.1016/j.jmig.2019.09.788.
  8. Champaneria R, Abedin P, Daniels J, et al. Ultrasound scan and magnetic resonance imaging for the diagnosis of adenomyosis: systematic review comparing test accuracy. Acta Obstet Gynecol Scand 2010;89(11):1374–1384. DOI: 10.3109/00016349.2010.512061.
  9. Bird CC, McElin TW, Manalo-Estrelia P. The elusive adenomyosis of the uterus—revisited. Am J Obstet Gynecol 1972;112:583–593. DOI: 10.1016/0002-9378(72)90781-8.
  10. Owolabi TO, Strickler RC. Adenomyosis: a neglected diagnosis. Obstet Gynecol 1977;50(4):424–427.
  11. Cullen TS. Adenoma-myoma uteri diffusum benignum. Johns Hopkins Hosp Bull 1896;6:133.
  12. Kumar CRA. Clinicopathological and radiological comparison of adenomyosis in hysterectomy patients–a retrospective study. Global J Res Anal 2019;8(10). DOI: 10.36106/gjra/0600459.
  13. Hunter W, Smith L, Reiner W. Uterine adenomyosis, incidence, symptoms, and pathology in 1,856 hysterectomies. Am J Obstet Gynecol 1947;53(4):663–668.
  14. Mechsner S, Grum B, Gericke C, et al. Possible roles of oxytocin receptor and vasopressin-1α receptor in the pathomechanism of dysperistalsis and dysmenorrhea in patients with adenomyosis uteri. Fertil Steril 2010;94(7):2541–2546. DOI: 10.1016/j.fertnstert.2010.03.015.
  15. Matalliotakis IM, Kourtis AI, Panidis DK. Adenomyosis. Obstet Gynecol Clin North Am 2003;30(1):63–82. DOI: 10.1016/s0889-8545(02)00053-0.
  16. Cirpan TE, Yeniel O, Ulukus M, et al. Clinical symptoms and histopathological findings in subjects with adenomyosis uteri. Clin Exp Obstet Gynecol 2008;35(1):48–53.
PDF Share
PDF Share

© Jaypee Brothers Medical Publishers (P) LTD.