Clinicopathological characteristics and imaging findings to identify adenomyosis‐related symptoms

PURPOSE: The study aims to identify the clinicopathological risk factors and magnetic resonance (MR) imaging findings for adenomyosis‐related symptoms, including menorrhagia, dysmenorrhea, and infertility. METHODS: This was an observation‐based cross‐sectional study using data from the adenomyosis cohort study. The authors evaluated the clinicopathological variables and various MR imaging findings. RESULTS: Two hundred twenty patients with histologically confirmed adenomyosis were included in this study. Multivariate analysis showed that a middle/retroflexed uterus and adenomyosis lesions of 21 mm or more were significant independent predictors of dysmenorrhea. The history of dysmenorrhea and the maximum length from the cervix to the uterine fundus ≥103 mm were independent risk factors of menorrhagia. One of the key factors associated with non‐infertility included the absence of deep infiltrating endometriosis (DIE) and/or superficial peritoneal disease (SUP). CONCLUSIONS: This study identified clinicopathological risk factors and imaging findings associated with adenomyosis‐related symptoms. The maximum length from the cervix to the uterine fundus and adenomyosis lesion thickness are independent predictors for the presence of menorrhagia and dysmenorrhea, respectively. Infertility may be associated with the coexistence of endometriosis rather than adenomyosis itself. This result is from an analysis of a small number of infertility patients and requires further study.