Adenomyoma and leiomyoma: Differential diagnosis with transvaginal sonography

Laparoscopic excision of uterine adenomyomas

“…In the majority of adenomyomas, the circumference of the lesion merges with the neighboring myometrium. These features, together with the presence of cystic areas within the lesion, are the key findings for the ultrasound differential diagnosis of uterine adenomyomas (sensitivity, 82.0%; specificity, 88.3%) (36) from uterine leiomyomas (sensitivity, 95.1%; specificity, 82.0%) (36). MRI is rather impractical for the initial evaluation of women with vague complaints suggestive of adenomyosis because it has limited availability and it is expensive.…”

Elastosonography: a possible new tool for diagnosis of adenomyosis?

“…All examinations were performed with Hitachi logos HI Vision equipped with an elastosonographic module and a 4-8 MHz endovaginal transducer. In accordance with previous studies, the diagnosis of adenomyosis was made when all of the following criteria were present: globular, rounded configuration of the uterus, defined as a regularly enlarged uterus; asymmetry of the anteroposterior wall of the myometrium; poorly defined endometrialmyometrial junction; myometrial cyst, defined as a round anechoic area with a diameter of 1-7 mm; subendometrial echogenic linear striations that are hyperechoic and located near the endometrial-myometrial interface; heterogeneous myometrium, defined by the presence of an indistinctly defined myometrial area with decreased or increased echogenicity [1,2,4,[7][8][9][10][11][12][13]. The B-mode parameters were set as follows: Frequency resolution, H; Angle, 5; MAP B/W, 3; DR, 80; H. Rez, +1; GAIN, 13. In addition to receiving a complete, traditional ultrasound assessment, all patients underwent an evaluation of peri-and intralesional vascularisation with Power Doppler (PD) analysis of possible areas of adenomyosis (Power Doppler parameters were set as follows: PFR, 0.5 KHz; colour map, 1; Density, 3; CFM filter, M; Persistence, 3; Smoothing, 1; CFA Dyn, 2; GAIN, 43).…”

A systematic review of transvaginal ultrasonography, sonohysterography and hysteroscopy for the investigation of abnormal uterine bleeding in premenopausal women

“…Heterogeneity was significant and therefore no pooled data are presented. One study used a greater than 8‐mm endometrial thickness as a cut off but had an increased number of false positives and a LR of 1.00 (0.16, 6.17) (14), one study used 10 mm as a cut off (17), three used 12 mm (12,23,26) and one used 14 mm but missed some pathology and therefore the authors suggested that a lower cut off of <12 mm was preferable for premenopausal women (27). In one study, no cut off was stated (25).…”