Objectives 23% (10/43) and 45% (5/11) (P = 0.027), and at least one total defect was seen in 6% (7/108), 7% (3/43) and 18% (2/11) (P = 0.336). In women who had undergone one Cesarean section, the median distance between an intact scar and the internal cervical os was 4.6 (range, 0-19)

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Objectives

What are the novel findings of this work?In this modified Delphi study, 13 experts on ultrasound diagnosis of adenomyosis reached consensus on revised definitions of the Morphological Uterus Sonographic Assessment (MUSA) features of adenomyosis and classified these into direct and indirect sonographic signs of adenomyosis. What are the clinical implications of this work?The revised definitions of MUSA features of adenomyosis and the distinction between direct and indirect signs should facilitate recognition and diagnosis of adenomyosis in clinical practice. The updated definitions are important for future studies on the relationship between the MUSA features of adenomyosis and clinical symptoms and reproductive outcome.