Adenomyosis Part 3 - Ultrasound Features
Take Home Points
findings we consider definitive for the diagnosis
- Myometrial cysts. These can be in the immediate subendometrial portion of the myometrium or deeper in the muscle
- Enlarged globular (gourd-shaped) uterus
- Again, we do not call the uterus enlarged until > 12 cm in length
- Asymmetric wall thickening
- Sub-endometrial echogenic striations
- Venetian-blind shadowing emanating from the myometrium rather than a mass
what feature leads to over-diagnosing adenomyosis?
- "Heterogeneous" myometrium. This is more of a judgement call. What appears heterogeneous to some, may not to others. It is our feeling that this is the predominant cause of the increase in ultrasound diagnosis of the disease.
- While it is true that adenomyosis can lead to heterogeneity, we usually like to see at least one additional finding above before diagnosing adenomyosis.
- We generally feel that some description of the degree of adenomyosis is important.
- Again, this is a judgement call and up to individuals discretion.