Adenomyosis in endometriosis—prevalence and impact on fertility. Evidence from magnetic resonance imaging

Kunz, G.; Beil, D.; Huppert, Peter; Noe, M.; Kissler, Stefan; Leyendecker, G.

doi:10.1093/humrep/dei021

Cited by 350 publications

(302 citation statements)

References 37 publications

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“…The cause of adenomyosis is unknown, but interesting theories have considered adenomyosis a pathology of the endo-myometrial junctional zone, and have attempted to explain the association of adenomyosis with subfertility and endometriosis [73,74].…”

Section: Adenomyosismentioning

confidence: 99%

“…These peristaltic disorders of the junctional zone have also been linked to dysmenorrhoea and menorrhagia, and may play a role in the pathogenesis of endometriosis by facilitating retrograde menstruation and implantation of viable endometrial cells into the abdominal cavity [73,81]. Pelvic endometriosis, especially in severe stages, is also strongly associated with junctional zone thickening [73,74,83,84]. Observational studies suggest that perturbations in junctional zone structure or functions before conception predispose towards a spectrum of fertility and obstetrical complications [85].…”

Section: The Endo-myometrial Junctional Zonementioning

confidence: 99%

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Imaging for the evaluation of endometriosis and adenomyosis

Exacoustòs

Manganaro

Zupi

2014

Best Practice & Research Clinical Obstetrics & Gynaecol

211

143

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Endometriosis affects between 5 and 45% of women in reproductive age, is associated with significant morbidity, and constitutes a major public health concern. The correct diagnosis is fundamental in defining the best treatment strategy for endometriosis. Therefore, non-invasive methods are required to obtain accurate diagnoses of the location and extent of endometriotic lesions. Transvaginal sonography and magnetic resonance imaging are used most frequently to identify and characterise lesions in endometriosis. Subjective impression by an experienced sonologist for identifying endometriomas by ultrasound showed a high accuracy. Adhesions can be evaluated by real-time dynamic transvaginal sonography, using the sliding sign technique, to determine whether the uterus and ovaries glide freely over the posterior and anterior organs and tissues. Diagnosis is difficult when ovarian endometriomas are absent and endometriosis causes adhesions and deep infiltrating nodules in the pelvic organs. Magnetic resonance imaging seems to be useful in diagnosing all locations of endometriosis, and its diagnostic accuracy is similar to those obtained using ultrasound. Transvaginal ultrasound has been proposed as first line-line imaging technique because it is well accepted and widely available. The main limitation of ultrasound concerns lesions located above the rectosigmoid junction owing to the limited field-of-view of the transvaginal approach and low accuracy in detecting upper bowel lesions by transabdominal ultrasound. A detailed non-invasive diagnosis of the extension in the pelvis of endometriosis can facilitate the choice of a safe and adequate surgical or medical treatment

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Section: Adenomyosismentioning

confidence: 99%

Section: The Endo-myometrial Junctional Zonementioning

confidence: 99%

Imaging for the evaluation of endometriosis and adenomyosis

Exacoustòs

Manganaro

Zupi

2014

Best Practice & Research Clinical Obstetrics & Gynaecol

211

143

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“…17,19,21,[29][30][31] The aim of our study was to evaluate the JZ ultrasound features in patients with endometriosis. We tried to detect a correlation between endometriosis and adenomyosis in the case of JZ modifications.…”

Section: Commentmentioning

confidence: 99%

“…6,16,17 Pelvic endometriosis, especially in severe stages, also is associated strongly with JZ thickening. [18][19][20][21] Therefore, the evaluation of JZ and its alterations by noninvasive imaging seems very important especially in patients with endometriosis.…”

mentioning

confidence: 99%

The uterine junctional zone: a 3-dimensional ultrasound study of patients with endometriosis

Exacoustòs

Luciano

Corbett

et al. 2013

American Journal of Obstetrics and Gynecology

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“…Today, evidence is accumulating that also the presence of endometriosis is accompanied by JZ abnormalities and there is extensive literature demonstrating that endometriosis, particularly in more severe stages, is associated with structural changes in the JZ or inner myometrium, including increased thickness and adenomyosis [39][40][41][42] . In addition, studies of the JZ in women with endometriosis showed that modifications leading to the development of adenomyosis, represented by an increased diameter of the dorsal JZ of the uterus at magnetic resonance imaging, had already commenced early in the third decade of life and, in these women, progressed steadily during the fourth decade 43 .…”

Section: Reunifying the Two Conditionsmentioning

confidence: 99%

Adenomyosis and endometriosis have a common origin

Benagiano

Brosens

2011

J Obstet Gynecol India

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The presence of epithelial cells in the peritoneal cavity and within the myometrium was described during the second part of the 19th century and was given the name "adenomyoma". Then, with the identification of peritoneal endometriosis in the 1920s, adenomyosis became a separate nosological entity. For decades, the two abnormalities have been considered separate benign proliferative conditions of the female reproductive tract with a different clinical profile. More recently, however, evidence has been accumulated indicating that these two diseases have in common an endometrial dysfunction involving both eutopic and heterotopic endometrium causing a reaction in the inner myometrium (the so-called myometrium junctional zone (JZ)). It therefore seems that adenomyosis and endometriosis share a common origin in an abnormal eutopic endometrium and myometrium JZ. It is therefore no surprise that both conditions are associated with obstetrical disorders, such as spontaneous preterm delivery and premature preterm rupture of the membranes, which may have roots in a disturbed decidualization and placentation process.

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Adenomyosis in endometriosis—prevalence and impact on fertility. Evidence from magnetic resonance imaging

Abstract: With a prevalence of up to 90%, uterine adenomyosis is significantly associated with pelvic endometriosis and constitutes an important factor of sterility in endometriosis presumably by impairing uterine sperm transport.

Cited by 350 publications

References 37 publications

Imaging for the evaluation of endometriosis and adenomyosis

Imaging for the evaluation of endometriosis and adenomyosis

The uterine junctional zone: a 3-dimensional ultrasound study of patients with endometriosis

Adenomyosis and endometriosis have a common origin

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