What tests should be done for adenomyosis

What tests should be done for adenomyosis?

How is adenomyosis diagnosed?

1. Ultrasound examination

The uterus is enlarged, the myometrium is thickened, and the posterior wall is more obvious, causing the endometrial line to move forward. Compared with the normal myometrium, the lesion is usually isoechoic or slightly more echogenic, sometimes point-like hypoechoic, and there is no obvious boundary between the lesion and the surrounding area. Vaginal ultrasound examination can improve the positive rate and accuracy of diagnosis.

2. Hysterography

In the past, iodized oil contrast imaging showed that iodized oil entered the myometrium, with a positive rate of about 20%. Later, some people used hydrogen peroxide solution acoustic contrast imaging, believing that it could increase the positive rate.

3. Endoscopic examination

Hysteroscopy shows that the uterine cavity is enlarged, and sometimes abnormal gland openings can be seen. If the endometrium and the suspicious tissue underneath are dug out with an electric knife for pathological examination, a clear diagnosis can sometimes be made. Laparoscopy shows that the uterus is uniformly enlarged, the anterior-posterior diameter is more obvious, the uterus is hard, gray or dark purple, and there are some serous bubbles on the surface. Sometimes purple and blue nodules protrude from the serous surface.

4. CA125 assay

55 cases of adenomyosis, 20 cases of uterine fibroids, and 20 cases of normal women had blood CA125 levels. The blood CA125 level of patients with adenomyosis increased significantly, with a positive rate of 80%. It was also found that the CA125 level of patients with adenomyosis was positively correlated with the size of the uterus. The larger the size of the uterus, the higher the CA125 level. Compared with before surgery, the CA125 level of patients decreased significantly one week after surgery. This shows that CA125 determination not only has obvious auxiliary diagnostic value for adenomyosis, but also helps to identify uterine fibroids.

5. Magnetic resonance

It is recognized as the most reliable non-invasive diagnostic method for adenomyosis both at home and abroad, but due to its high price, decisions affecting surgical treatment can only be made by relying on other non-invasive diagnostic methods.