title: Four subtypes of adenomyosis assessed by magnetic resonance imaging and their specification.
abstract: OBJECTIVE
  The aim of the present study was to differentiate and specify the subtypes of adenomyosis.
  
  
  METHODS
  Surgically treated adenomyosis (n = 152) was subcategorized retrospectively into 4 subtypes on the basis of magnetic resonance imaging geography. Subtype I (n = 59) consisted of adenomyosis that occurs in the uterine inner layer without affecting the outer structures. Subtype II (n = 51) consisted of adenomyosis that occurs in the uterine outer layer without affecting the inner structures. Subtype III (n = 22) consisted of adenomyosis that occurs solitarily without relationship to structural components. Adenomyosis that did not satisfy these criteria composed subtype IV (n = 20). Stepwise logistic regression analysis was used for specification of the subtypes.
  
  
  RESULTS
  Subtypes I-III were suggested as a product of direct endometrial invasion, endometriotic invasion from the outside, and de novo metaplasia, respectively. Subtype IV was a heterogeneous mixture of far advanced disease.
  
  
  CONCLUSIONS
  Adenomyosis appears to consist of 3 distinct subtypes of different causes and an additional subtype of indeterminate cause.
authors: Department of Obstetrics and Gynecology, Takanohara Central Hospital, Nara, Japan. kishi@takanohara-ch.or.jp
authors: Yohei
authors: Y
authors: Kishi
authors: Hiroshi
authors: H
authors: Suginami
authors: Rihoko
authors: R
authors: Kuramori
authors: Maki
authors: M
authors: Yabuta
authors: Rumiko
authors: R
authors: Suginami
authors: Fumiaki
authors: F
authors: Taniguchi
mesh_terms: D000328:Adult; D004715:Endometriosis / Q000145:classification* / Q000473:pathology* / Q000601:surgery; D005260:Female; D006801:Humans; D016015:Logistic Models; D008279:Magnetic Resonance Imaging; D010049:Ovarian Diseases / Q000145:classification* / Q000473:pathology* / Q000601:surgery; D012189:Retrospective Studies; D014591:Uterine Diseases / Q000145:classification* / Q000473:pathology* / Q000601:surgery