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Sonographic Findings in Patients with Adenomyosis: Can Sonography Assist in Predicting Extent of Disease?

Carol A. Hulka1,2, Deborah A. Hall1, Kathleen McCarthy1 and Joseph Simeone1

1 Department of Radiology, Massachusetts General Hospital, 55 Fruit St., Boston, MA 02114.
2 Present address: Department of Radiology, Cambridge Health Alliance, 1493 Cambridge St., Cambridge, MA 02139.



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  		Fig. 1A. —44-year-old woman with severe adenomyosis. Sagittal endovaginal sonogram of uterus shows diffusely heterogeneous myometrium (arrows) consistent with severe adenomyosis that was found on histologic review of specimen.

 


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  		Fig. 1B. —44-year-old woman with severe adenomyosis. Transverse sonogram of uterus shows diffusely heterogeneous myometrium (arrows) consistent with severe adenomyosis.

 


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  		Fig. 2. —47-year-old woman with diffuse adenomyosis and fibroids. Sagittal endovaginal sonogram of uterus shows diffuse heterogeneous process and poor visualization of endometrium that are consistent with diffuse adenomyosis and fibroids that were confirmed on histologic review of specimen.

 


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  		Fig. 3. —52-year-old woman with adenomyoma. Transverse sonogram of uterus shows single posterior myometrial nodule with hypoechoic rim (arrowhead) that was confirmed as adenomyoma on histologic review of specimen. Because of its subtle sonographic appearance, this nodule was detected only after knowledge of diagnosis.

 


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  		Fig. 4. —48-year-old woman with severe adenomyosis. Transverse sonogram of uterus in region of fundus shows multiple cystic spaces scattered throughout myometrium. Histologic examination showed diffuse severe adenomyosis with fluid-filled endometrial glands that corresponded to cystic spaces on sonography.

 

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