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Journal of Diagnostic Medical Sonography
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Adenomyosis

A Novel Approach Using Transvaginal Power Doppler Sonography

Gabriele Tonni, MD, PhD

Department of Obstetrics-Gynaecology, ASL Reggio Emilia—Guastalla Civil Hospital, Reggio Emilia, Italy, Tonni.Gabriele{at}ausl.re.it

Alessandro Ventura, MD

Department of Obstetrics-Gynaecology, ASL Reggio Emilia—Guastalla Civil Hospital, Reggio Emilia, Italy

The present study confirms the potential use of transvaginal power Doppler sonography in the field of pelvic inflammatory disease such as endometriosis, as well as its usefulness in the subtle differential instrumental diagnosis between adenomyosis and leiomyomata. Transvaginal power Doppler application is critical in studying the vascular tree of such lesions and can aid clinicians in planning the most appropriate therapeutic strategy. The differential diagnosis using power Doppler sonography is based on vascular characteristics. Adenomyosis is characterized by a preserved vascular texture supply that results in dilated spiral arteries running perpendicular toward the myometrium into the endometrial surface. Leiomyomata exhibits a vascular tree that typically circumscribes the solid mass. Nodular stage II adenomyosis in young, infertile patients may be treated with a conservative hysteroscopic resection of the myometrium under laparoscopic guidance. 2D or 3D transvaginal power Doppler angiography should be used to improve diagnostic sensitivity and facilitate appropriate therapeutic intervention.

Key Words: power Doppler • adenomyosis • leiomyomata • 2D ultrasound • 3D ultrasound

Journal of Diagnostic Medical Sonography, Vol. 21, No. 3, 267-272 (2005)
DOI: 10.1177/8756479305274584
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