Cօntemporary approaches of ultrasound diagnostics of adenomyosis: review of literature

ABSTRACT

Despite the widespread prevalence of adenomyosis, both clinical and fundamental research on this condition has been hindered by inconsistent terminology and the absence of a universally accepted standard classification of lesions. The development of high-resolution imaging techniques, particularly magnetic resonance imaging (MRI) and transvaginal ultrasound (TVUS), which have demonstrated similarly good overall effectiveness, marked a turning point in understanding adenomyosis. Ultrasound characteristics of adenomyosis reflect its histological features. Transvaginal ultrasound allows for detailed visualization of the endometrium, junctional zone, and myometrium. To describe ultrasound patterns of adenomyosis, the terms and definitions from MUSA (Morphological Uterus Sonographic Assessment), developed in 2015 by leading experts to standardize the terminology of myometrial lesions, should be used. According to the Consensus, seven parameters should be documented during ultrasound diagnostics of adenomyosis. Examination of the endometrium and myometrium using expert-class ultrasound equipment allows for the detection of adenomyosis at its earliest stages, which led to the assertion that adenomyosis can be diagnosed with high accuracy using transvaginal ultrasound without histological verification. Different morphological types identified by ultrasound may reflect various stages of disease progression and could have distinct clinical significance concerning symptomatology, fertility, obstetric outcomes, and therapeutic options.