The following tests may be done during your diagnostic workup. As you will see, it is extremely important to seek out a physician who has been trained in adenomyosis diagnosis and treatment. Currently, the best way to diagnose adenomyosis OTHER than an hysterectomy is 2D/3D transvaginal ultraound or MRI. Again, adenomyosis may be missed if the technologist/physician is not trained well in adenomyosis. It is imperative that a woman with adenomyosis seek out a well-trained physician with extensive knowledge in adenomyosis and/or endometriosis.
Endometrial biopsy – Usually performed to determine the reason for abnormal menstrual bleeding, a sample of tissue is taken from the endometrium. This procedure may or may not pick up adenomyosis if it is present. If the adenomyosis is not present where the biopsy is taken, it will result in a false negative result.
Hysterosalpinography (hysterosonogram) – Using a catheter and contrast medium, this procedure allows the physician to visualize the inside of the uterus. This procedure is not generally suggested for use in the diagnosis of adenomyosis; however, IF the radiologist/physician is well-trained in adenomyosis, it may be picked up due to it’s irregular appearance – cystic lesions and/or abnormal vascularization. This is why it is important to search for physicians who are well-trained in adenomyosis diagnosis and treatment.
Hysteroscopy – This is similar to but more invasive than a hysterosalpinography. During this surgery, a physician can take a biopsy, remove fibroids and/or remove polyps. Again, this procedure is generally not suggested to diagnose adenomyosis UNLESS the doctor is well-trained.
2D/3D Transvaginal Ultrasound – This procedure MAY be useful in the diagnosis of adenomyosis, but only if the technician/radiologist/physician are well trained. Common signs of adenomyosis on ultrasound include a large uterus, an asymmetrical myometrium, and a poorly defined junctional zone.
Magnetic Resonance Imaging (MRI) – This imaging study has become extremely valuable in the diagnosis of adenomyosis. Recent studies have shown that an area in the uterine wall called the junctional zone is thickened in adenomyosis, and an MRI can effectively visualize this area. It has been noted that a junctional zone in the uterus greater than 12 mm is highly suggestive of adenomyosis. Other signs of adenomyosis on MRI include ill-defined low signal intensity within the junctional zone and T2 hyperintense myometrial cysts.