{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,13]],"date-time":"2026-10-13T04:35:05Z","timestamp":1791866105712,"version":"4.3.4"},"reference-count":101,"publisher":"MDPI AG","issue":"1","license":[{"start":{"date-parts":[[2022,12,30]],"date-time":"2022-12-30T00:00:00Z","timestamp":1672358400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100001809","name":"National Natural Science Foundation of China","doi-asserted-by":"publisher","award":["82071623"],"award-info":[{"award-number":["82071623"]}],"id":[{"id":"10.13039\/501100001809","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100001809","name":"National Natural Science Foundation of China","doi-asserted-by":"publisher","award":["2017ZZ01016"],"award-info":[{"award-number":["2017ZZ01016"]}],"id":[{"id":"10.13039\/501100001809","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100001809","name":"National Natural Science Foundation of China","doi-asserted-by":"publisher","award":["SHDC2020CR2062B"],"award-info":[{"award-number":["SHDC2020CR2062B"]}],"id":[{"id":"10.13039\/501100001809","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100003399","name":"Science and Technology Commission of Shanghai Municipality","doi-asserted-by":"publisher","award":["82071623"],"award-info":[{"award-number":["82071623"]}],"id":[{"id":"10.13039\/501100003399","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100003399","name":"Science and Technology Commission of Shanghai Municipality","doi-asserted-by":"publisher","award":["2017ZZ01016"],"award-info":[{"award-number":["2017ZZ01016"]}],"id":[{"id":"10.13039\/501100003399","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100003399","name":"Science and Technology Commission of Shanghai Municipality","doi-asserted-by":"publisher","award":["SHDC2020CR2062B"],"award-info":[{"award-number":["SHDC2020CR2062B"]}],"id":[{"id":"10.13039\/501100003399","id-type":"DOI","asserted-by":"publisher"}]},{"name":"Shanghai Shenkang Center for Hospital Development","award":["82071623"],"award-info":[{"award-number":["82071623"]}]},{"name":"Shanghai Shenkang Center for Hospital Development","award":["2017ZZ01016"],"award-info":[{"award-number":["2017ZZ01016"]}]},{"name":"Shanghai Shenkang Center for Hospital Development","award":["SHDC2020CR2062B"],"award-info":[{"award-number":["SHDC2020CR2062B"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>Adenomyosis is a complex and poorly understood gynecological disease. It used to be diagnosed exclusively by histology after hysterectomy; today its diagnosis is carried out increasingly by imaging techniques, including transvaginal ultrasound (TVUS) and magnetic resonance imaging (MRI). However, the lack of a consensus on a classification system hampers relating imaging findings with disease severity or with the histopathological features of the disease, making it difficult to properly inform patients and clinicians regarding prognosis and appropriate management, as well as to compare different studies. Capitalizing on our grasp of key features of lesional natural history, here we propose adding elastographic findings into a new imaging classification of adenomyosis, incorporating affected area, pattern, the stiffest value of adenomyotic lesions as well as the neighboring tissues, and other pathologies. We argue that the tissue stiffness as measured by elastography, which has a wider dynamic detection range, quantitates a fundamental biologic property that directs cell function and fate in tissues, and correlates with the extent of lesional fibrosis, a proxy for lesional \u201cage\u201d known to correlate with vascularity and hormonal receptor activity. With this new addition, we believe that the resulting classification system could better inform patients and clinicians regarding prognosis and the most appropriate treatment modality, thus filling a void.<\/jats:p>","DOI":"10.3390\/jcm12010287","type":"journal-article","created":{"date-parts":[[2022,12,30]],"date-time":"2022-12-30T03:18:18Z","timestamp":1672370298000},"page":"287","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":14,"title":["In Search of an Imaging Classification of Adenomyosis: A Role for Elastography?"],"prefix":"10.3390","volume":"12","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8511-7624","authenticated-orcid":false,"given":"Sun-Wei","family":"Guo","sequence":"first","affiliation":[{"name":"Research Institute, Shanghai Obstetrics & Gynecology Hospital, Fudan University, Shanghai 200011, China"},{"name":"Shanghai Key Laboratory of Female Reproductive Endocrine-Related Diseases, Fudan University, Shanghai 200011, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3168-4594","authenticated-orcid":false,"given":"Giuseppe","family":"Benagiano","sequence":"additional","affiliation":[{"name":"Faculty of Medicine and Dentistry, Sapienza, University of Rome, 00161 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marc","family":"Bazot","sequence":"additional","affiliation":[{"name":"Department of Radiology, Tenon University Hospital, Assistance Publique des H\u00f4pitaux de Paris (AP-HP), Sorbonne Universit\u00e9, 75012 Paris, France"},{"name":"Groupe de Recherche Clinique (GRC-6), Centre Expert en Endom\u00e9triose (C3E), Assistance Publique des H\u00f4pitaux de Paris, Tenon University Hospital, Sorbonne Universit\u00e9, 75000 Paris, France"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2022,12,30]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"583","DOI":"10.1016\/0002-9378(72)90781-8","article-title":"The elusive adenomyosis of the uterus\u2014Revisited","volume":"112","author":"Bird","year":"1972","journal-title":"Am. 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