Patient's question:
Hello! I am 32 years old and have one child. In 2002, I was diagnosed with adenomyosis. It initially improved in May 2005, but I became pregnant again in June and had a miscarriage. Now my condition is very bad again, with pain starting a day or two before my period and lasting for seven or eight days after. For half a month each month, I am in agony from the pain and need painkillers to manage it. Here is the ultrasound description: The uterus measures 65x59x71, is well-shaped, and has uneven muscle layer echoes. There is a slightly stronger echo area measuring 50x35mm on the posterior wall, with unclear boundaries. The endometrium is shifted 9mm posteriorly. Near the fundus of the uterine cavity, there is a slightly stronger echo mass approximately 9x7mm in size. The rectal fossa measures 28x10mm.Doctor's answer:
The ectopic endometrium is entirely located within the uterine myometrium. In color Doppler ultrasound, the lesions of adenomyosis show rich blood flow. The high-echoic foci are surrounded by slow-moving arterial and venous blood in a speckled or short-stick pattern. On MRI, the ectopic endometrium appears as high-signal intensity, with or without microcystic cavities of bleeding, surrounded by proliferating myofibers forming microuterine structures. It is supplied by small branches of the uterine artery, indicating that the ectopic endometrial lesions of adenomyosis are all vascularized through the uterine artery. This provides a vascular anatomical basis for interventional treatment.