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• Adenomyosis : 5 minute...
Adenomyosis
- Common in multiparous
- 40 yr
- - 30% of hysterectomy specimens
Endometriosis interna
A/s
Menorrhagia
Progressive dysmenorrhea
Diagnosis
Usg
- Subendometrial halo
- Heteroechoic deposito along the muscle in uterine myometrium
- Ill-defined hypoechoic areas - lakes of endometrial blood In uterine muscle
- Junction zone ,n = 5-8 mm , more than12 mm s/o adenomyosis
Junctional zone is a region representing the inner myometrium and is a very important imaging feature in pelvic MR imaging for interpretation of various pathologies.
Magnetic resonance MR imaging is a highly accurate noninvasive modality for diagnosis of adenomyosis, differentiation of adenomyosis from other gynecologic disorders, and planning of appropriate treatment.
* Differentiate localised adenomyoma and fibroid- lack distinct borders and usually posterior
*
Uterine biopsy / post hysterectomy uterus
pathophysiology:
- endometrial gland within uterine muscle can be seen
TREATMENT
* Depends on age and desire for future fert
* Secondary dysmenorrhea- NSAIDS & OCPs
* GnRH agonists, LNG-IUS
* Medical management- not very effective
*
* Total hysterectomy (parous women more than 40
* Resection (younger women, localised adenomyosis)
7 авг 2024
