Adenomiosis: Guía para la evaluación ultrasonográfica

Abstract

Adenomyosis, initially defined by Cullen in 1908 and distinguished from other types of endometriosis by Sampson in 1921,
has seen significant improvements in its diagnosis thanks to advances in ultrasound and magnetic resonance imaging
(MRI), which have increased its detected incidence. Since its introduction in the 1980s, ultrasound technology has evolved
with high-resolution endocavitary transducers and 3D ultrasound, allowing for detailed assessment of the disease, especially in the endometrial junction zone. Although MRI offers higher resolution images, studies have shown little significant
difference in diagnostic value between the two techniques for adenomyosis, positioning ultrasound as a valuable initial
diagnostic tool due to its safety, low cost, and availability. Ultrasonographic criteria for diagnosis include the identification
of hyperechoic nodules, myometrial cysts, and alterations in uterine vascularization and structure, reflecting the underlying histopathological changes of the disease. The diagnostic accuracy significantly depends on the sonographer’s experience, underscoring the importance of training in the interpretation of these ultrasonographic signs. Hence, the importance
of understanding the ultrasonographic criteria of this disease allows for early diagnosis and timely management.