04/07/2024
The sub-endometrium is typically less than 1 cm thick or less than the width of a finger. When the sub-endometrium exceeds 1.2 cm, it is due to a condition called adenomyosis. This is often accompanied by cystic changes in the sub-endometrium which are easily seen on a magnetic resonance imaging exam of the pelvis but often misdiagnosed on ultrasound imaging. That is why MRI makes it the gold standard for imaging fibroids or adenomyosis.
While the uterine enlargement from significant adenomyosis is often appreciated on pelvic ultrasound, the thickening of the sub-endometrium and cystic changes are often missed. Not uncommonly, the patientβs adenomyosis is not recognized or mistakenly diagnosed as uterine fibroids.
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