title: The uterine junctional zone: a 3-dimensional ultrasound study of patients with endometriosis.
abstract: OBJECTIVE
  The uterine junctional zone (JZ) alterations are correlated with adenomyosis. An accurate evaluation of the JZ may be obtained by 3-dimensional transvaginal sonography (TVS). The aim of the present prospective study was to assess the value of detectable alterations by 3-dimensional TVS of the JZ in patients with pelvic endometriosis (diagnosed by laparoscopy and histologic condition) and to compare these findings with those of women without pelvic endometriosis.
  
  
  METHODS
  Eighty-two patients who were scheduled for laparoscopy had undergone previous surgery and 2- and 3-dimensional TVS. Uterine multiplanar sections that were obtained by 3-dimensional TVS were used to evaluate JZ features. During laparoscopy, an accurate staging of pelvic endometriosis was performed. JZ thickness and JZ alterations were correlated with stage of endometriosis.
  
  
  RESULTS
  Of the 82 patients, 59 patients had endometriosis at laparoscopy and histology. The maximum thickness of JZ in patients with endometriosis was significantly greater than in patients without endometriosis (6.5 ± 1.9 mm vs 4.8 ± 1.0 mm; P < .001). The features of JZ appeared similar at different stages, whereas they are statistically different if correlated with patients without endometriosis.
  
  
  CONCLUSIONS
  JZ thickness and its alterations are different in patients with endometriosis compared with those women without endometriosis and are not correlated with American Society of Reproductive Medicine staging methods. Because these JZ ultrasound features are associated mostly with adenomyosis, a correlation between endometriosis and JZ hyperplasia and adenomyosis could be hypothesized. Noninvasive evaluation of the JZ may be useful in the identification of those women who are affected by endometriosis also in early stage of the disease when there are no other sonographic signs of pelvic endometriosis.
authors.affiliation: Department of Obstetrics and Gynecology, Università degli Studi di Roma Tor Vergata, Rome, Italy. caterinaexacoustos@tiscali.it
authors.forename: Caterina
authors.initials: C
authors.lastname: Exacoustos
authors.forename: Danielle
authors.initials: D
authors.lastname: Luciano
authors.forename: Brenda
authors.initials: B
authors.lastname: Corbett
authors.forename: Giovanna
authors.initials: G
authors.lastname: De Felice
authors.forename: Mara
authors.initials: M
authors.lastname: Di Feliciantonio
authors.forename: Anthony
authors.initials: A
authors.lastname: Luciano
authors.forename: Errico
authors.initials: E
authors.lastname: Zupi
mesh_terms: D062788:Adenomyosis / Q000473:pathology; D000328:Adult; D004715:Endometriosis / Q000473:pathology*; D005260:Female; D006801:Humans; D011446:Prospective Studies; D014463:Ultrasonography; D014599:Uterus / Q000000981:diagnostic imaging* / Q000473:pathology*; D055815:Young Adult
keywords: 3-dimensional transvaginal sonography; adenomyosis; endometriosis; junctional zone