{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,12]],"date-time":"2026-10-12T23:12:32Z","timestamp":1791846752928,"version":"4.3.4"},"reference-count":31,"publisher":"MDPI AG","issue":"14","license":[{"start":{"date-parts":[[2023,7,21]],"date-time":"2023-07-21T00:00:00Z","timestamp":1689897600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>Adenomyosis is a commonly diagnosed benign condition characterized by the presence of ectopic endometrial glands within the underlying myometrium. The most common presenting signs and symptoms are abnormal uterine bleeding, chronic pelvic pain, and infertility. The clinical relevance of this condition is evident in both medical and surgical care. Histopathology and imaging studies are used for the diagnosis and classification of adenomyosis, which are hallmarks of the advancement of our ability to diagnose adenomyosis. Importantly, the diagnosis and classification of adenomyosis lacks standardization due to the nature of imaging techniques, features of adenomyosis, and the clinical spectrum of adenomyosis. We reviewed the literature to summarize the available classification systems for adenomyosis and highlight the different imaging approaches and histologic criteria used in diagnosis. Despite the high prevalence of the disease, there is no clear consensus on one classification system. We provide a review of some of the classification systems available and discuss their strengths and limitations.<\/jats:p>","DOI":"10.3390\/jcm12144828","type":"journal-article","created":{"date-parts":[[2023,7,24]],"date-time":"2023-07-24T01:15:45Z","timestamp":1690161345000},"page":"4828","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":77,"title":["Adenomyosis: An Updated Review on Diagnosis and Classification"],"prefix":"10.3390","volume":"12","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3240-1496","authenticated-orcid":false,"given":"Gaby","family":"Moawad","sequence":"first","affiliation":[{"name":"Department of Obstetrics and Gynaecology, The George Washington University Hospital, Washington, DC 20037, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8958-6049","authenticated-orcid":false,"given":"Arrigo","family":"Fruscalzo","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, HFR\u2014H\u00f2pital Fribourgeois, Chemin des Pensionnats 2-6, 1708 Fribourg, Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4339-333X","authenticated-orcid":false,"given":"Youssef","family":"Youssef","sequence":"additional","affiliation":[{"name":"Division of Minimally Invasive Gynecologic Surgery, Department of Obstetrics and Gynaecology\u2014Maimonides Medical Center, Brooklyn, NY 11219, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7426-5923","authenticated-orcid":false,"given":"Mira","family":"Kheil","sequence":"additional","affiliation":[{"name":"Department of Obstetrics & Gynecology, Henry Ford Health, Detroit, MI 48202, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tala","family":"Tawil","sequence":"additional","affiliation":[{"name":"Department of Pathology, Henry Ford Health, Detroit, MI 48202, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jimmy","family":"Nehme","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Henry Ford Health, Detroit, MI 48202, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8947-6109","authenticated-orcid":false,"given":"Paul","family":"Pirtea","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynaecology and Reproductive Medicine, Hopital Foch\u2013Facult\u00e9 de M\u00e9decine Paris, 92150 Suresnes, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4498-3734","authenticated-orcid":false,"given":"Benedetta","family":"Guani","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, HFR\u2014H\u00f2pital Fribourgeois, Chemin des Pensionnats 2-6, 1708 Fribourg, Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Huda","family":"Afaneh","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, Women\u2019s Health Institute, Cleveland Clinic Foundation, Cleveland, OH 44195, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jean Marc","family":"Ayoubi","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynaecology and Reproductive Medicine, Hopital Foch\u2013Facult\u00e9 de M\u00e9decine Paris, 92150 Suresnes, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9817-9445","authenticated-orcid":false,"given":"Anis","family":"Feki","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, HFR\u2014H\u00f2pital Fribourgeois, Chemin des Pensionnats 2-6, 1708 Fribourg, Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2023,7,21]]},"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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