Transvaginal ultrasound of a 36-year-old woman with dysmenorrhea and heavy bleeding shows a globular uterus with asymmetric thickening of the anterior myometrial wall and small anechoic myometrial cysts. Which finding is the most specific sonographic marker supporting adenomyosis?
- A Globular uterine outline
- B Myometrial cysts ✓
- C Asymmetric wall thickening
- D Fan-shaped shadowing
Correct answer: B. Myometrial cysts
Explanation
Small anechoic or hypoechoic myometrial cysts represent cystically dilated ectopic endometrial glands and are the most specific ultrasound feature of adenomyosis, though they are seen in only a minority of cases. Globular enlargement, asymmetric wall thickening, fan-shaped shadowing, and heterogeneous echotexture are common but less specific signs also seen with leiomyomas or physiological variation. The presence of cysts essentially confirms ectopic endometrial tissue within the myometrium.
Reference: Williams Gynecology, 4th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
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