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. 2022 Dec 30;12(1):287. doi: 10.3390/jcm12010287

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© 2022 by the authors.

Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).

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Transvaginal ultrasound image for a patient with a small uterus (59 × 58 × 57 mm) who complained of moderate dysmenorrhea with elevated CA125 level and was suspected with AM. (A) The big, circled area (white arrows) showed the ROI. The conventional B-mode TVUS image showed no sign that was consistent with a typical or spherical enlarged uterus or the presence of mild but not severe or obvious internal inhomogeneous echo in ROI. (B) Transvaginal elastosonography image showing an increased stiffness value (LFI = 2.585) in the same ROI shown in the TVUS (white arrow), indicative of adenomyosis. AM indicates adenomyosis; LFI, liver function index; ROI, region of interest; TVUS, transvaginal ultrasound. Replicated from Liu et al. [71] (Reprinted with permission from Reproductive Sciences).