Adenomyosis is a benign gynaecological disorder defined by the presence of ectopic endometrial glands and stroma within myometrium with subsequent hypertrophy and hyperplasia of smooth muscle (1). It is usually associated with dysmenorrhea, uterine bleeding disorders, chronic pelvic pain and dyspareunia as well asit is strongly associated also with the presence of lifelong infertility (2,3,4). In most cases, the imaging work-up of infertile women begins with hysterosalpingography to evaluate fallopian tube patency and transvaginal ultrasound (TVUS) but typically requires further characterization with pelvic magnetic resonance...

50infertile women who underwent both TVUS and 1.5T MRI from January 2014 to December 2017 were retrospectively reviewed. The inclusion criteria were: female infertility without hormonal causes normal male spermiogram while the exclusion criterion was: incorrect cycle phase. 4 infertile women were excluded because they underwent 1.5T MRI during the incorrect cycle phase (menstrual phase) and for this reason, finally, we considered 46 patients (average age 38.5 years, range 23-46 years). All transvaginal ultrasounds were performed by an expert gynaecologist using a high frequency (5-9...

Concerningthe diagnosis of adenomyosis, TVUS resulted negative in 61% of cases, it diagnosed a focal form of adenomyosis in 22% of cases and a diffuse form in 17% of cases while 1.5T MRI risulted negative in 26% of cases, it diagnosed a focal form of adenomyosis in 30% of cases and a diffuse form in 44% of cases (Fig.9). Using 1.5T MRI as the gold standard, TVUS demonstrated a sensitivity of 41%, a specificity of 67%, a positive predictive value of 78% and a negative...

MRI should be included in the diagnostic pathway of infertile women because TVUS has a limited diagnostic accuracy in the detection of adenomyosis, especially in case of associated findings. In relation to its high specificity and high positive predictive value, if TVUS is positive and if MUSA critera are satisfied,the clinician can start GnRHa therapy even without performingMRI. If TVUS is positive, MRI should be performedbefore starting the treatment in case of a planned IVF, in order to do the follow up ofthe lesions correctly...

Federica Arban, MD; Natalia Starvaggi, MD; Lorella Bottaro, MD; Maria Assunta Cova, MD;SC (UCO) di Radiologia Diagnostica ed Interventistica, University of Trieste; Italy. Fabiola Giudici, Biostatistic Unit-Department of Health Sciences, University of Trieste; Italy. Marco Gergolet, MD; S.I.F.E.S. doo Bohoričeva 5, Ljubljana, Slovenia.

1. Campo S, Campo V, Benagiano G. Adenomyosis and infertility. ReprodBiomedonline. 2012; 24(1):35-46. 2. Hong SC, Khoo CK. An update on adenomyosis uteri. Gynaecol Minim Invasive Ther. 2016; 5(3):132-3. 3. Benagiano G, Habiba M, Bronses I. The pathophisiology of uterine adenomyosis: an update. Fertil Steril. 2012; 98(3):572-9. 4. Younes G, Tulandi T. Effects of adenomyosis on in vitro fertilization treatment outcomes: a meta-analysis. Fertil Steril. 2017; 108(3)483-490. 5. Van Den Bosch T, Dueholm M, Leone FPG, Valentin L, Rasmussen CK, Votino A, et al. Terms,...