Myometriosis, a form of endometriosis, is called myometriosis (also known as adenomyosis) when the endometrial glands and mesenchyme invade the myometrium. It used to be called intrinsic endometriosis, while endometriosis in the non-myometrium layer was called extrinsic endometriosis to show the difference. Myometriosis occurs most often in menstruating women aged 30-50 years, with about half of the patients also having a combination of fibroids and about 15% having a combination of endometriosis. Although serial sectioning of autopsies and specimens of uterus removed for disease revealed endometrial tissue in 10%-47% of myometrium, only 70% of them had clinical symptoms. Serial sectioning of specimens with adenomyosis revealed that some of the endometrial lesions in the myometrium were directly connected to the endometrium on the uterine cavity surface, so it is generally believed that trauma to the uterine wall during multiple pregnancies and deliveries and chronic endometritis may be the main causes of this disease. In addition, due to the lack of submucosal layer under the basal lining of the endometrium and the fact that adenomyosis is often combined with uterine fibroids and overgrowth of the endometrium, it is thought that the invasion of the basal endometrium into the myometrium may be related to the stimulation of high estrogen. Examination methods 1. Imaging is the most effective means of preoperative diagnosis of this disease. Vaginal ultrasonography has a sensitivity of 80% and a specificity of 74%, which is more accurate than the abdominal probe. MRI can be used to objectively understand the location and extent of the lesion before surgery, which is helpful in deciding the treatment method. In diffuse adenomyosis, MRI shows diffuse thickening of the uterine binding zone on T2WI; in limited adenomyosis, T2WI shows a low-signal mass with similar signal to the binding zone and blurred borders. 2, serum CA125 Some patients with adenomyosis have elevated serum CA125 levels, which are valuable in monitoring the efficacy of treatment. Diagnosis The clinical diagnosis of uterine adenomyosis depends mainly on medical history. Any woman within 35 years of age who presents with secondary, progressively increasing dysmenorrhea and whose uterus is found to be enlarged and hard on examination should first consider the possibility of uterine adenomyosis. The disease can be clinically diagnosed when the uterus is found to be enlarged, softer and with pressure pain before menstruation or on the 1st to 2nd day of menstruation when another gynecological examination is performed. Since some patients have no symptoms or atypical symptoms, and the uterus is not significantly enlarged or has an irregular shape with myoma-like prominence, preoperative diagnosis is often missed or misdiagnosed. Imaging is helpful but non-specific for diagnosis.