Uterine myoma and adenomyosis: sonographic findings and differentiation

Uterine myoma and adenomyosis are the two most likely diagnoses in women with hypermenorrhea, dysmenorrhea,and an enlarged uterus, but it is often not possible to make a distinctyion between them preoperatively. But their treatments can differ: muyoma can be treated through myomectomy whereas adenomyosis requires hysterectomy. Inorder to estaablish the characteristic and differential findins of myoma and adenomyosis sonographically, sosnogaphic findings of 125 cases of pathologically proven myom a and adenomyosis were reviewed retrospectively.Histologic diagnoses were myoma in 94 paitents and adenomyosis in 31 patients. The results were as follows: 1. The common sonographic findings of uterine myoma were glovular enlargement or bulging contour of uterus 77.8%, loss ofcentral endometrial echoes 66.0%, and homogeneous decreased internal echoes 35.1% or heterogeneous internal echoes44.7%. 2. The common sonographic findings of adenomyosis were diffuse enlargement without contour change 80.6%,homogeneous hypoechoic or isoechoic internal textures 96.8%, presserved central endometrial echoes 80.6%, andthickening of posterior uterine wall 64.5%. 3. Adenomyosis was highly suggested if the uterus showed diffuse enlargenent without contour change or visible nodule, homogeneous hypoechoic textures, and especially thickened posterior wall with anteriorly displaced central endometrial echoes. 4. Adenomyosis could be excluded if the patient was under 30 or above 50 years old, and especially had no previous obstetric history.