Correlations Between Ultrasound Features and Histological Findings in Adenomyosis: A Single-Center Retrospective...

Area of Science:

• Gynecologic pathology
• Medical imaging
• Diagnostic techniques

Background:

• Adenomyosis, a benign gynecologic condition, involves endometrial tissue within the myometrium.
• Histology of hysterectomy specimens is the diagnostic gold standard, but classification remains challenging.
• Chronic pelvic pain, abnormal uterine bleeding, and infertility are key symptoms.

Purpose of the Study:

• To evaluate the diagnostic correlation of transvaginal ultrasound (TVUS), 3D ultrasonography, and Doppler with adenomyosis histology.
• To assess the relationship between adenomyosis location, symptoms, and co-existing deep endometriosis.

Main Methods:

• Observational retrospective study of 160 women with adenomyosis undergoing hysterectomy.
• All patients underwent transvaginal sonography with 3D and Doppler imaging prior to surgery.
• Ultrasound findings were compared with histological examination of hysterectomy specimens.

Main Results:

• A statistically significant correlation was found between ultrasound-observed adenomyosis location and histological findings (p=0.0001).
• Specific symptoms correlated with lesion location: heavy periods with internal adenomyosis (p≤0.001), infertility (p=0.001), and pelvic pain with external adenomyosis (p=0.03).
• Deep endometriosis was associated with external adenomyosis (p=0.001), and ill-defined junctional zones on Doppler correlated with symptoms (p=0.0001).

Conclusions:

• Three-dimensional transvaginal ultrasound (3D TVUS) with Doppler enhances diagnostic accuracy for adenomyosis, aligning with histological results.
• This noninvasive imaging modality supports therapeutic decisions, including uterus-preserving options.
• Accurate diagnosis via 3D TVUS facilitates tailored treatment strategies for adenomyosis.