Diagnosis of Adenomyosis
Overview
In the intricate world of women’s health, there exists a condition that is often not easy to spot —adenomyosis.
Adenomyosis, marked by the abnormal presence of endometrial tissue within the uterus’s muscular walls, can give rise to various issues, affecting the lives of numerous individuals.
The diagnosis of adenomyosis is often considered an intricate process, requiring a keen understanding of the symptoms presented and the available diagnostic tools.
Adenomyosis: Symptoms
Adenomyosis is a medical condition characterized by the abnormal growth of endometrial tissue, which typically lines the uterus, into the muscular walls of the uterus.
This can cause various symptoms, such as:
- Enlarged uterus
- Feelings of abdominal bloating, fullness or heaviness
- Heavy bleeding during periods
- Discomfort and pain during intercourse
- Pelvic pain
- Severe cramps during periods
It’s important to note that these symptoms are not exclusive to adenomyosis and can overlap with other gynecological conditions such as endometriosis or fibroids. If you are experiencing any of these symptoms, it’s crucial to consult with a healthcare professional for a proper diagnosis and appropriate management.
Adenomyosis: How to Diagnose?
Adenomyosis can be challenging to diagnose as its symptoms overlap with other uterine conditions like fibroids, endometriosis, and endometrial polyps.
Here are some common methods for the diagnosis of adenomyosis:
Diagnosing adenomyosis begins with a consultation with a Gynecologist.
After detailed medical history, Doctor will perform a pelvic examination, which might reveal a bulky uterus that could be double or triple the normal size.
As a widely available and relatively inexpensive technique, Transvaginal ultrasound is the first option in the evaluation of adenomyosis. Adenomyosis could be suspected and diagnosed based on following findings:
- Uterus is bulky and globular.
- Focal or diffuse areas of myometrial hypoechogenicity.
- Within the thickened heterogeneous myometrium, small cysts may be seen (in 50%).
- Focal lesions with poor margin, often lacking mass effect.
- Linear striations radiating out from the endometrium
MRI is the best imaging tool to confirm a diagnosis of adenomyosis. The high-resolution images offered by MRI provide valuable insights into conditions like adenomyosis, ensuring accurate and informed medical decisions.
MRI allows the detection of other coexisting gynecologic conditions (e.g., fibroids or other manifestations of endometriosis) and the evaluation of surrounding pelvic structures.
Sensitivity and specificity rates of MRI are reaching up to 90% in diagnosing Adenomyosis.
MR imaging findings in women with adenomyosis are:
Bulky Uterus:
o Diffusely enlarged uterus
o Thickening and asymmetry of the anterior or posterior uterine walls
Thickened Junctional Zone:
o Thickened Junctional zone (inner portion of myometrium layer), more than > 12 mm, is the hallmark of adenomyosis.
o Predominantly it affects the posterior uterine wall.
- Visualized as hypointense signals with scattered bright foci within on T2 weighted imaging.
Focal adenomyomas:
o Localized low-signal myometrial mass of adenomyosis often with high-signal foci within.
o Adenomyoma have poorly defined borders with relative absence of mass effect unlike fibroids.
Cystic adenomyosis:
o Small (2-7 mm), well-circumscribed, cystic myometrial lesions (50% of patients).
o These cystic foci correspond to islands of heterotopic endometrial tissue, cystic dilatation of heterotopic glands, or hemorrhagic foci.
o High signal linear striations radiating out from the endometrium on T2 W imaging (pseudo enlargement of the endometrium).
It’s essential to make the right diagnosis as further treatment and outcome would be based on it.
If you are experiencing symptoms suggestive of adenomyosis, it is crucial to consult with Dr. Sandeep in Dubai. Dr. Sandeep will study your MRI imaging and determine the most appropriate approach based on your individual case.
Adenomyosis: Diffuse globular bulky uterus with thickened T2 hypointense transitional zone (asterisk)and tiny T2 hyperintense foci within.
Focal Adenomyosis also known as Adenomyoma (asterisk), involving posterior uterine wall. Unlike fibroid, adenomyosis has ill- defined margin with surrounding myometrium.
Comprehensive Adenomyosis Care: Your Health in Dr.. Sandeep's Hands
Dr. Sandeep, a dedicated fibroid and adenomyosis expert in Dubai, employs a comprehensive, patient-centered approach to diagnosing and treating adenomyosis. His proficiency in utilizing various diagnostic tools reflects his commitment to delivering precise and personalized care to each patient.
With a wealth of experience, he navigates diverse options—medical management, hormonal therapies, or minimally invasive interventions—to create a customized plan aligned with your health goals.
