Evaluation of magnetic resonance imaging in adenomyosis / 解放军医学杂志

ABSTRACT

Objective To evaluate the MR manifestation to provide guidance for the clinical diagnosis of adenomyosis.Methods The MR images of 43 cases of adenomyosis which were proved by operation and pathology were reviewed.Results Among the 43 cases of adenomyosis,26 cases were of diffuse adenomyosis and 17 of focal adenomyosis.Leiomyoma(21 cases),intra-pelvic cavity chocolate cyst (17 cases)and ovarian cyst(15 cases)were concurrently found in this group of patients.The MRI of diffuse adenomyosis demonstrated an enlarged uterus and widened uterine junction zone with ill-defined margin between junction zone and myometrium.The adenomyosis lesions showed iso-signal intensity on T_1 weighted images and iso-signal or slight low signal intensity on T_2 weighted images with scattered hyper- intense foci.The uterine cavities were irregularly narrowed due to compression of thickening junction zone.The lesions showed mild con- trast enhancement on contrast-enhanced MR images.The MRI of focal adenomyosis displayed localized myometrial masses with ill-defined margin with widening of junction zone.The lesions were round or oval in shape with iso-signal intensity on T_1 weighted images and inho- mogeneous slightly low signal on T_2 weighted images.Multiple scattered hyperintense foci could be found in the mass on the T_2 weighted images.The lesions had mild contrast enhancement on contrast-enhanced MR images.The concurrent leiomyoma,intra-pelvic cavity choc- olate cyst and ovarian cyst were also displayed by MR imaging.Conclusion The widened junction zone is the characteristic change of ade- nomyosis.MRI can demonstrate the types,size and concurrent changes in adenomyosis,and is a useful noninvasive imaging method for the diagnosis of adenomyosis.