Title : The association of adenomyosis with endometriosis based on pelvic magnetic resonance imaging
Abstract:
Background: Endometriosis is a chronic inflammatory disease that is defined by the presence of endometrial glands and stroma outside the uterine cavity. Uterine adenomyosis is the presence of ectopic endometrial tissue in the myometrium, sometimes considered a spectrum of endometriosis.
Purpose: The purpose of this study was to evaluate the association of uterine adenomyosis with endometriosis based on the findings in pelvic magnetic resonance imaging.
Methods: In an analytical descriptive study, 42 women of reproductive age with diagnosis of endometriosis who were referred to the Gynecology Clinics of Islamic Azad University of Mashhad were studied. All patients were candidate for open surgery or laparoscopy. The variables of the study included the age of menarche, length of menstrual period, body mass index (BMI), gravidity, history of infertility and history of previous pelvic surgery. Data were collected by face-to-face interview with each patient. All patients underwent pelvic MRI for mapping of pelvic endometriosis before surgery. The presence of concurrent adenomyosis was investigated at the same time. MRI was performed with a Siemens 1.5 Tesla machine with and without IV contrast. MR images were interpreted by a radiologist with five years of experience in the field of endometriosis imaging. Data were analyzed using SPSS 25 software. P value of less than 0.05 was considered significant.
Results: The mean age of the women in this study was 32.07 years. In 17 (40.5%) patients adenomyosis was associated with endometriosis, three of them (7.1 %( had focal adenomyosis and the rest had diffuse adenomyosis. Among the researched variables, the association of adenomyosis with endometriosis was significantly higher in patients with BMI more than 25. Other variables did not show any significant difference. After surgery, according to the American Society for Reproductive Medicine (ASRM) classification, all patients had severe endometriosis (stage III and IV (.
Conclusion: The results of this study showed that more than one third of patients with severe endometriosis, had MRI findings of uterine adenomyosis.
Keywords: Adenomyosis, Endometriosis, Magnetic Resonance Imaging.
Audience Take Away:
- Diagnostic role of MRI in pelvic endometriosis.
- Diagnostic role of MRI in uterine adenomyosis.
- Risk factors and associations of pelvic endometriosis and uterine adenomyosis.
