TY - JOUR
T1 - Adenomyosis in pregnancy
T2 - Diagnostic pearls and pitfalls
AU - Jensen, Kyle K.
AU - Pyle, Chelsea
AU - Foster, Bryan R.
AU - Sohaey, Roya
AU - Oh, Karen
N1 - Publisher Copyright:
© RSNA, 2021.
PY - 2021/5/1
Y1 - 2021/5/1
N2 - Adenomyosis is a common benign uterine disorder in which ecto-pic endometrial glands extend into the myometrium. Adenomyosis is increasingly diagnosed in young women, affecting 20%–35% of women of reproductive age. Features of adenomyosis can be seen with either US or MRI, especially with newer imaging technology. With advances in reproductive endocrinology as well as a trend toward later maternal age, adenomyosis is increasingly noted during pregnancy, often while performing imaging for other reasons. Hormonal changes during pregnancy alter the appearance of ad-enomyosis, which includes diffuse, focal, and cystic adenomyosis. Recognizing these imaging changes in pregnancy proves essential for accurately diagnosing adenomyosis as a benign condition, as it mimics serious placental and myometrial abnormalities. Using a lower-frequency US transducer or MRI can be helpful in distin-guishing among these entities. Describing the location of adeno-myosis in relationship to the site of placentation is also important. Diagnosing adenomyosis is crucial because it can be associated with poor pregnancy outcomes, including spontaneous abortion, preterm birth, and fetal growth restriction. Adenomyosis is also a risk factor for preeclampsia. Intramural ectopic pregnancy is a rare but serious condition that can mimic cystic adenomyosis, and comparison with prepregnancy images can help differentiate the two conditions. The authors review the unique imaging characteristics of adenomyosis in pregnancy, focusing on accurate diagnosis of an underrecognized benign condition that can mimic myometrial and placental pathologic conditions.
AB - Adenomyosis is a common benign uterine disorder in which ecto-pic endometrial glands extend into the myometrium. Adenomyosis is increasingly diagnosed in young women, affecting 20%–35% of women of reproductive age. Features of adenomyosis can be seen with either US or MRI, especially with newer imaging technology. With advances in reproductive endocrinology as well as a trend toward later maternal age, adenomyosis is increasingly noted during pregnancy, often while performing imaging for other reasons. Hormonal changes during pregnancy alter the appearance of ad-enomyosis, which includes diffuse, focal, and cystic adenomyosis. Recognizing these imaging changes in pregnancy proves essential for accurately diagnosing adenomyosis as a benign condition, as it mimics serious placental and myometrial abnormalities. Using a lower-frequency US transducer or MRI can be helpful in distin-guishing among these entities. Describing the location of adeno-myosis in relationship to the site of placentation is also important. Diagnosing adenomyosis is crucial because it can be associated with poor pregnancy outcomes, including spontaneous abortion, preterm birth, and fetal growth restriction. Adenomyosis is also a risk factor for preeclampsia. Intramural ectopic pregnancy is a rare but serious condition that can mimic cystic adenomyosis, and comparison with prepregnancy images can help differentiate the two conditions. The authors review the unique imaging characteristics of adenomyosis in pregnancy, focusing on accurate diagnosis of an underrecognized benign condition that can mimic myometrial and placental pathologic conditions.
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U2 - 10.1148/rg.2021200120
DO - 10.1148/rg.2021200120
M3 - Article
C2 - 33769889
AN - SCOPUS:85105926070
SN - 0271-5333
VL - 41
SP - 929
EP - 944
JO - Radiographics
JF - Radiographics
IS - 3
ER -