From Clinical Symptoms to MR Imaging: Diagnostic Steps in Adenomyosis

Krentel, Harald; Cezar, Cristina; Becker, Sven; Sardo, Attilio Di Spiezio; Tanos, Vasilios; Wallwiener, Markus; Wilde, Rudy Leon De

doi:10.1155/2017/1514029

Cited by 27 publications

(23 citation statements)

References 48 publications

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“…The characteristics of uterine fibroid hyalinosis in MRI are moderate intensity in TIW1 and low intensity in T2W1, while uterine fibroids mucinous degeneration has a characteristic of high intensity in T2W1, sometimes characterized by multiple patches, without reinforcement in the enhanced scan. MRI can not only reflect the characteristic signal of the tumor to identify the position and size but also identify the complex uterine malformations, which is the best diagnostic method for the disease[11].…”

Section: Discussionmentioning

confidence: 99%

Intrauterine cystic adenomyosis: Report of two cases

Liu

2019

WJCC

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BACKGROUND Cystic adenomyosis is a special type of adenomyosis. Its clinical manifestations lack specificity. Pelvic ultrasound and nuclear magnetic resonance imaging can help clarify the diagnosis. Because cystic uterine adenomyosis is rare in clinical work, it can be easily misdiagnosed or its diagnosis can be missed. Early surgical treatment and postoperative drug treatment can alleviate dysmenorrhea, menorrhagia, anemia, and other symptoms. CASE SUMMARY Two cases complained about abnormal vaginal bleeding and were diagnosed with intrauterine cystic adenomyosis by gynecological ultrasound and pathological examination. The clinical manifestations included dysmenorrhea, hypermenorrhea, and a history of cesarean section. Both cases underwent a surgery, and chocolate-like liquid was released from the cystic mass in the uterus and the manifestations were relieved. CONCLUSION Intrauterine cystic adenomyosis could be diagnosed by pathological examination and treated by hysterectomy or hystscopy to release the liquid inside.

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Section: Discussionmentioning

confidence: 99%

Intrauterine cystic adenomyosis: Report of two cases

Liu

2019

WJCC

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“…There was significant reduction in median dysmenorrhea from VAS (3)(4) to (2)(3), there was significant change in medina VAS score from 3 months to 6 months after using Marina 2 (1-2), there was significant change in median VAS score from 6 months to 12 months after using Marina 0 (0-1), and finally there was no significant change from 12 months to 24 months after using Marina 0 (0-1), as illustrated in Fig. 2.…”

Section: Resultsmentioning

confidence: 88%

“…The basic clinical characters of the participants are shown in Table 1. The mean age of the women was 44.5±2.5 (39-49) years, and the mean number of parity was 3.6±0.9 (2)(3)(4)(5)(6). Before insertion of LNG-IUS, the mean menstrual blood loss using PMAC was 144.1±25.9 ml, mean pain 3.65±1.04 using VAS, and the mean uterine volume was 139.8±33.2.…”

Section: Resultsmentioning

confidence: 99%

“…A reliable diagnose of adenomyosis can be made by the combination of clinical history, gynecological examination, and transvaginal 2D and 3D ultrasound. In addition, Doppler sonography and magnetic resonance imaging might help to determine adenomyosis, especially in cases with combined uterine fibroids [3]. The diagnosis depends on triad of clinical manifestations composed of the abnormal uterine bleeding (50%), secondary dysmenorrhea (30%), and an enlarged, tender uterus [4].…”

Section: Introductionmentioning

confidence: 99%

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Levonorgestrel-Releasing Intrauterine System in Adenomyosis; Predictors for Response and Clinical Outcome

Alizzi

Showman

Fawzi

2018

Asian J Pharm Clin Res

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Objectives:The aim is to detect clinical and ultrasonographic characters that predict the response of adenomyosis to levonorgestrel-releasing intrauterine system (LNG-IUS) and to evaluate the clinical efficacy and the time needed to show a response. Methods:A prospective single-arm study conducted in the Obstetrics and Gynaecology Department Al-Yarmouk Teaching Hospital in Baghdad/Iraq from August 2015 to March 2018. Women with symptomatic adenomyosis with age 39 years and above and who completed their families had been enrolled in this study. LNG-IUS was used as a treatment; the outcome measure was to evaluate its effect in improving the symptoms and the time needed to show a clinical response. Multivariate analysis was used to assess the contribution of the clinical and ultrasonographic parameters to the prediction of the response to LNG-IUS. Results:Over the mean duration of follow-up period of the study (22.7±9.9 months), there was a significant improvement in menstrual blood loss, dysmenorrhea, and hemoglobin (Hb) with significant decrease in uterine volume (p˂0.001). The time to show response was as early as 3 months and the first 6 months is the best time to predict failure. Initial menstrual blood loss and Hb were good predictors to show response while uterine volume an excellent one (positive predictive value 80% and negative predictive value 97.2%). Conclusion:Levonorgestrel-releasing intrauterine device is an effective treatment of symptomatic adenomyosis in term of time to response and duration of response. The presenting Hb, menstrual blood loss, and uterine volume are useful predictors of response.

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“…Adenomyosis might also be the reason for persistent symptoms after surgical interventions for peritoneal and deep endometriosis [5]. The gynecological examination may reveal a dolorous enlarged uterus and an additional palpable deep endometriosis of the retrocervical area [6]. Almost 50% of patients with deep endometriosis also have an involvement of the uterus.…”

Section: From Anamnesis To Transvaginal Ultrasound-the Diagnosismentioning

confidence: 99%

Adenomyosis: diagnostics and treatment

Krentel¹,

Wilde

2020

Gynäkologe

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Background Adenomyosis is a frequent additional condition in patients with endometriosis and should be included in diagnostic and treatment concepts. Objective Description of diagnostic and therapeutic approaches in patients with adenomyosis in relation to patient age, family planning status, peritoneal and/or deep endometriosis and symptoms. Methods The current literature on adenomyosis including case reports was analyzed. Due to the lack of evidenced-based approaches the most probable trends in diagnostics and treatment are discussed. Results Adenomyosis plays an important role in fertile patients with dysmenorrhea, dyspareunia and pelvic pain, with or without additional peritoneal or deep endometriosis. It has a negative impact on fertility and can cause a variety of symptoms. The disease can be diagnosed by a skilled examiner and treatment concepts exist. Conclusion Adenomyosis can be diagnosed by a combination of clinical history, gynecological examination, transvaginal ultrasound and magnetic resonance imaging. Various medical and surgical treatment approaches are available to reduce symptoms and to increase fertility. The course of action depends on the family planning status of the patient.

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From Clinical Symptoms to MR Imaging: Diagnostic Steps in Adenomyosis

Cited by 27 publications

References 48 publications

Intrauterine cystic adenomyosis: Report of two cases

Intrauterine cystic adenomyosis: Report of two cases

Levonorgestrel-Releasing Intrauterine System in Adenomyosis; Predictors for Response and Clinical Outcome

Adenomyosis: diagnostics and treatment

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