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Bulky retroverted uterus. Diffuse myometrial thickening (with the transitional zone thickness about 18 mm) showing heterogenous echopattern, multiple tiny echogenic nodular striations, few tiny anechoic myometrial cysts and mild increased vascularity on Doppler scan.
Transvaginal ultrasound is reported to be as sensitive (89%) and specific (89%) as MRI in diagnosis of uterine adenomyosis.
The most common ultrasound features of adenomyosis include asymmetrical myometrial thickening, transitional zone thickening >12 mm, heterogeneous myometrial echopattern, myometrial echogenic linear or nodular striations (specific sign) and associated increased blood flow, as well as the "venetian blind" pattern of acoustic shadowing.