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Diffuse and Focal Adenomyosis: MR Imaging Findings¹

¹ From the Department of Radiology, Kangnam St Mary's Hospital, College of Medicine, Catholic University of Korea, 505 Banpo-dong, Seocho-ku, Seoul 137-040, Korea. Presented as a scientific exhibit at the 1998 RSNA scientific assembly. Received January 28, 1999; revision requested April 16 and received May 10; accepted May 11. Address reprint requests to J.Y.B.

Adenomyosis is a common gynecologic disorder that affects women during their menstrual life. Preoperative magnetic resonance (MR) images obtained in 45 patients with pathologically proved adenomyosis who underwent hysterectomy were retrospectively reviewed. Diffuse adenomyosis was seen in 30 cases (66.7%) and focal adenomyosis in 15 cases (33.3%). On T2-weighted MR images, diffuse adenomyosis usually manifested as diffuse thickening of the endometrial-myometrial junctional zone (7–37 mm; mean, 16 mm) with homogeneous low signal intensity. T2-weighted MR images were superior to contrast material–enhanced T1-weighted images in the evaluation of junctional zone thickening. High-signal-intensity foci were observed on T2-weighted images only in nine cases and on both T1- and T2-weighted images in three cases. Focal adenomyosis manifested on both T2-weighted and contrast-enhanced T1-weighted MR images as a localized, low-signal-intensity round or oval mass with a diameter of 2–7 cm (mean, 3.8 cm). All but one of the focal lesions had ill-defined margins. High-signal-intensity foci were noted in all cases of focal adenomyosis, either on T2-weighted images only (four cases) or on both T1- and T2-weighted images (11 cases). MR imaging is useful in diagnosing adenomyosis, differentiating adenomyosis from uterine myoma, and planning appropriate treatment.

Index Terms: Endometriosis, 854.3192 • Leiomyoma, 854.315 • Uterus, diseases, 854.3142, 854.317 • Uterus, MR, 854.121411, 854.12143

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