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Pelvic Ultrasound for Endometriosis: General Features
Published in Nazar N. Amso, Saikat Banerjee, Endometriosis, 2022
Caterina Exacoustos, Lucia Lazzeri
Adenomyosis seems also to be associated with endometriosis (2–4,59,67). A strong association between adenomyosis, diagnosed by TVS, and endometriosis, with 48–50% incidence of adenomyosis in patients affected by DIE, was reported (2–4).
Adenomyomectomy
Published in Rooma Sinha, Arnold P. Advincula, Kurian Joseph, FIBROID UTERUS Surgical Challenges in Minimal Access Surgery, 2020
Anshumala Shukla Kulkarni, Fouzia Hayat
The main symptoms of adenomyosis are menorrhagia, dysmenorrhea, and subfertility. Moreover, adenomyosis may be associated with recurrent abortion, premature delivery, and complications of late pregnancy, such as placenta previa.
Ultrasound assessment of endometriosis
Published in Caroline Overton, Colin Davis, Lindsay McMillan, Robert W Shaw, Charles Koh, An Atlas of ENDOMETRIOSIS, 2020
The diagnosis of adenomyosis remains a particular issue from a medical imaging point of view. It is reasonable to say that, to date, magnetic resonance imaging (MRI) is regarded as perhaps the most effective modality in this respect, but presents obvious problems with regard to practical aspects and cost in particular. The availability of high-definition G-S imaging, as well as considerable advances in CDI techniques, has nevertheless had considerable impact in this respect. Diffuse myometrial thickening with irregular textural changes, enlargement of myometrial glands, poor differentiation of the myometrial-endometrial interface and, in particular, increased myometrial vascularity are all ultrasound features often found in cases of known endometriosis and/or confirmed adenomyosis.
Comparison of high-intensity focused ultrasound for the treatment of internal and external adenomyosis based on magnetic resonance imaging classification
Published in International Journal of Hyperthermia, 2023
Feng Xu, Zhenjiang Lin, Yangyang Wang, Chunmei Gong, Min He, Qing Guo, Zhibiao Wang, Zhang Lian
Clinically, around two-thirds of patients with adenomyosis are symptomatic and thus need to be treated [4]. The main symptoms of adenomyosis are dysmenorrhea and menorrhagia. This disease also has a great impact on the fertility of childbearing age women [5–7]. The diagnosis of adenomyosis is suspected by clinical evaluation and confirmed with ultrasound and magnetic resonance imaging (MRI). MRI offers the best soft tissue resolution and can clearly show the appearance of adenomyotic lesions in internal or external layers of the myometrium. The typical MRI features of adenomyotic lesions include ill-defined low signal intensity areas with hyperintensity foci in the lesions on T2-weighted images (T2WI) [8–9]. Kishi et al. classified adenomyosis as four types based on the location of adenomyotic lesion and the relationship between the lesion and the endometrium, junction zone, myometrium, and the serosa of the uterus revealed by MRI: type I (intrinsic), type II (extrinsicl), type III (intramural) and type IV (indeterminate) [10].
Comparison of pregnancy outcomes in infertile patients with different types of adenomyosis treated with high-intensity focused ultrasound
Published in International Journal of Hyperthermia, 2023
Jiajia Wei, Li Wang, Hua Tao, Xindan Wang, Fengque Zheng, Ping He, Linggang Zhou, Li Fan, Jing Chen, Haijing Zhong, Wenjie Huang, Dingyuan Zeng, Jingjing Li
As a noninvasive treatment, HIFU is performed under the guidance of ultrasound. The adenomyotic lesion was selectively ablated without damaging the surrounding structures. Thus, patients who undergo HIFU treatment can attempt to conceive more quickly than those who undergo surgical treatment and have a reduced likelihood of uterine rupture during pregnancy or delivery [35]. Therefore, HIFU treatment is an attractive alternative to traditional surgical methods for patients who wish to conceive. Due to its mild clinical symptoms and signs, adenomyosis is often overlooked, but it is prevalent in patients with infertility, abortive failure, and recurrent miscarriages. The classification of adenomyosis is closely associated with its likely mechanism of occurrence, treatment strategies, and therapeutic efficacy. Therefore, prior to treatment, adenomyosis imaging should be adequately evaluated.
Clinical efficacy and safety of trimonthly administration of goserelin acetate 10.8 mg in premenopausal Chinese females with symptomatic adenomyosis: a prospective cohort study
Published in Gynecological Endocrinology, 2023
Hao Sun, Ming Yuan, Xinyu Wang, Xue Jiao, Zangyu Pan, Hua Li, Linqing Yang, Liming Wang, Shihong Zhang, Qianhui Ren, Shumin Yan, Dong Li, Xinmei Zhang, Guoyun Wang
Adenomyosis is a common benign gynecological disease that refers to lesions caused by invasion of the endometrium (including glands and stroma) into the myometrium. It has been traditionally labeled an ‘elusive’ disease because the exact etiology and occurrence are unknown [1]. The main clinical symptoms of adenomyosis include dysmenorrhea, hypermenorrhea, and subfertility, which can seriously impact the physical and mental health of patients. Current treatments for adenomyosis include drugs, surgery, radiation, ultrasound intervention, or a combination of these approaches. Hysterectomy has traditionally been the definitive treatment for patients with adenomyosis. However, it is not suitable for patients with reproductive aspirations. Although fertility-sparing procedures such as adenomyomectomy and cytoreductive surgery are now available and may improve fertility, they may increase the risk of uterine rupture after pregnancy [2, 3]. Moreover, high-intensity focused ultrasound (HIFU) and uterine artery embolization (UAE) are also beneficial in treating adenomyosis. However, the long-term effects of these two techniques in managing adenomyosis and their impact on pregnancy remain to be further studied [4]. From the perspective of symptom relief and fertility promotion, medical treatment may be the first choice for patients with symptomatic adenomyosis.