Adenomyosis and leiomyoma: differential diagnosis with MR imaging.

Mark, Alexander S.; Hricak, Hedvig; Heinrichs, LeRoy; Hendrickson, Michael; Winkler, Marion F.; Bachica, J A; Stickler, J E

doi:10.1148/radiology.163.2.3562836

Cited by 172 publications

(119 citation statements)

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“…Dysperistaltism was also proposed to be responsible for the higher incidence of endometriosis in patients with a septate uterus in another study (22). Inner myometrial thickness of ≤5 mm is accepted as normal (23). In our control group, the mean inner myometrial thickness was 4.16±1.92 mm which was consistent with the literature.…”

Section: Discussionsupporting

confidence: 89%

Uterine Junctional Zone Thickness, Cervical Length and Bioelectrical Impedance Analysis of Body Composition in Women with Endometriosis

Ayas¹,

Bayraktar²,

Gürbüz³

et al. 2012

Balkan Med J

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Objective: We aimed to evaluate uterine junctional zone thickness, cervical length and bioelectrical impedance analysis of body composition in women with endometriosis.Material and Methods: This is a prospective study conducted in a tertiary teaching hospital. A total of 73 patients were included in the study. Endometriosis was surgically diagnosed in 36 patients (study group). The control group included 37 patients. Main outcome measure(s): Bioelectrical impedance analysis was used to measure body composition. Uterine junctional zone thickness and cervical length were measured by transvaginal ultrasonography.Results: Patients' characteristics (age, gravida, parity, live baby, age of menarche, lengths of menstrual cycle , percentage of patients with dysmenorrhea, positive family history), body mass index (BMI) (kg/m 2 ), amount of body fat (kg), percentage of body fat were not statistically different between the two groups (p>0.05). The length of menstruation and cervical length were longer in women with endometriosis. Similarly, the inner myometrium was thicker in women with endometriosis than the control group. Conclusion:The relation between endometriosis and demographic features such as age, gravida, parity, gravida, BMI, lengths of the menstrual cycle, age of menarche are controversial. Longer cervical length and thicker inner myometrial layer may be important in the etiopathogenesis of endometriosis.

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Section: Discussionsupporting

confidence: 89%

Uterine Junctional Zone Thickness, Cervical Length and Bioelectrical Impedance Analysis of Body Composition in Women with Endometriosis

Ayas¹,

Bayraktar²,

Gürbüz³

et al. 2012

Balkan Med J

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“…Several studies have demonstrated MR imaging to be highly accurate in diagnosis of adenomyosis, with a sensitivity and specificity of 86%-100% and an overall accuracy of 85%-90.5% (5,6,(11)(12)(13)(14).…”

Section: Accuracy Of Diagnosismentioning

confidence: 99%

Uterine Adenomyosis: Endovaginal US and MR Imaging Features with Histopathologic Correlation

Reinhold¹,

Tafazoli²,

Mehio³

et al. 1999

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Uterine adenomyosis is a common gynecologic condition that is characterized by the presence of heterotopic endometrial glands and stroma in the myometrium with adjacent smooth muscle hyperplasia. The histopathologic features of adenomyosis are varied and contribute to its imaging appearance. The accompanying smooth muscle hyperplasia produces the typical gross appearance of adenomyosis and corresponds to areas of decreased echogenicity at endovaginal ultrasonography (US) and areas of decreased signal intensity at magnetic resonance (MR) imaging. Endovaginal US also shows heterogeneity of the myometrial echotexture, which corresponds to small echogenic islands of heterotopic endometrial tissue surrounded by the hypoechoic smooth muscle. On T2-weighted MR images, bright foci are seen in areas of abnormal low signal intensity within the myometrium in approximately 50% of patients. These foci correspond to islands of heterotopic endometrial tissue, cystic dilatation of heterotopic glands, or hemorrhagic foci. With the advent of high-resolution imaging techniques, signs associated with the presence of heterotopic endometrial tissue are being detected with increasing frequency. These signs include myometrial cysts, myometrial nodules, linear striations, pseudowidening of the endometrium, and poor definition of the endomyometrial junction. Pitfalls in diagnosis of uterine adenomyosis include leiomyoma, endometrial carcinoma, myometrial contractions, and muscular hypertrophy.

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“…In addition, the presence of mural leiomyomas can limit the assessment of the adjacent myometrium with EVS. Several studies have demonstrated MR imaging to be highly accurate in diagnosing adenomyosis, with a sensitivity and specificity ranging from 86 to 100% (Mark et al, 1987;Togashi et al, 1988;Togashi et al, 1989;Hricak et al, 1992;Ascher et al, 1994;Reinhold et al, 1996). However, the high cost and limited availability of MR imaging makes it an impractical tool for the initial evaluation of all patients with symptoms suggestive of adenomyosis, as these are non-specific and are the presenting complaints for a large proportion of the gynaecological population.…”

Section: Magnetic Resonance Imagingmentioning

confidence: 99%