Adenomyosis: modern diagnostic possibilities

Objective. To assess comprehensive examination results in patients with adenomyosis. Subjects and methods. The investigation enrolled 59 reproductive-aged and premenopausal (40.5±6.2 years) patients with adenomyosis verified in 42 (71.2%) cases, with no concurrent uterine myoma, as well as 20 control group patients. The investigation used traditional methods, such as 3D ultrasound, magnetic resonance imaging, hysteroscopy and biopsy of the endometrium and myometrium, histological examination, and statistical methods. Results. The patients with adenomyosis were found to include persons who were younger than 35 years (28.8%), nulliparous (25.4%), and infertile (19.1%); those who had undergone peritoneal endometriosis (11.9%) or uterine (28.8%) surgeries; and those who had predominant dysmenorrhea (96.6%). The uterine volume was higher in 83.1% of adenomyosis patients than that in the control group (103.35±13.01 and 42.4±2.96 cm3, respectively; p=0.000); the myometrial wall asymmetry with a difference in the anterior and posterior wall thickness was 7.01±1.8 mm in 47.6% of patients; and the myometrial junctional zone thickness was >12 mm in 62.5%. There was an increased uterine radial and basal artery resistance index and reduced myometrial vascularization indices in comparison with the control (p<0.05). Conclusion. The presented diagnostic possibilities of traditional clinicomorphological studies and modern myometrial imaging techniques allow the timely detection of characteristic signs of adenomyosis.