What are parameters for the diagnosis of adenomyosis by transvaginal ultrasonography?

Updated: Dec 07, 2018
  • Author: Karen L Reuter, MD, FACR; Chief Editor: Eugene C Lin, MD  more...
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Answer

Answer

On sonograms, the most common appearance of adenomyosis is areas of decreased echogenicity or heterogeneity in the myometrium (see the images below). Di Donato et al described the following parameters as main criteria in the diagnosis of adenomyosis by TVS [11] :

  • Heterogeneous myometrium
  • Hyperechoic or hypoechoic linear striation in the myometrium
  • Myometrial anechoic lacunae or cysts
  • Subendometrial microcysts
  • Asymmetric myometrial thickening of the uterine wall
  • Global uterine enlargement
  • The question mark sign
  • Thickening of the junctional zone
  • Hyperechoic myometrial areas
Transvaginal sonogram of an enlarged uterus with a Transvaginal sonogram of an enlarged uterus with a thickened posterior myometrium (arrows).
Sagittal transabdominal sonogram of an enlarged ut Sagittal transabdominal sonogram of an enlarged uterus with a thickened posterior myometrium (arrows).

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