A Classification Proposal for Adenomyosis Based on Magnetic Resonance Imaging

Area of Science:

• Gynecology
• Radiology
• Medical Imaging

Background:

• Adenomyosis classification lacks international consensus, hindering clinical practice and research.
• Existing classifications do not fully capture the heterogeneity of adenomyosis.
• Magnetic resonance imaging (MRI) offers detailed visualization of adenomyosis morphology.

Purpose of the Study:

• To review advancements and limitations in adenomyosis classification.
• To propose a novel, clinically relevant classification system for adenomyosis.
• To establish a standardized approach for assessing adenomyosis severity and subtypes.

Main Methods:

• Comprehensive literature search of PubMed and Embase databases up to March 2019.
• Analysis of proposed adenomyosis classification parameters based on MRI findings.
• Review of clinical and research utility of existing classification systems.

Main Results:

• Adenomyosis is a heterogeneous condition with diverse subtypes, not a single entity.
• Proposed classification incorporates parameters like affected area, pattern, size, concomitant pathologies, and localization.
• A simplified classification system is suggested to correlate symptom severity with morphological types.

Conclusions:

• A standardized, MRI-based classification is needed for adenomyosis.
• The proposed system aims to improve disease assessment in clinical practice and research.
• Further studies are required to validate the proposed classification's utility.