Clinical Diagnosis of Adenomyosis with MRI

Objective:To evaluate the diagnostic value of adenomyosis with MRI.Methods:MRI features in 43 cases of adenomyosis confirmed by operation and pathology between January 2003 and December 2007 were studied retrospectively. Results:Among the 43 patients, ① 17 had diffuse adenomyosis, with enlarged, well-demarcated uterine by MRI. The lesions appeared isoechoic and not distinguishable from normal muscles on T1WI, while on T2WI,diffuse or local thickening of junctional zone were observed,or a local lump with indistinct margin in the exo-myometrium could be revealed; ② 26 had focal disease, on T2WI, the lesions were hypoechoic and ill-demarcated, similar to the junctional zone in signal intensity. On T1WI, non-enhancement or enhancement scanning revealed isoechoic lesions similar to muscles in signal intensity. Of the 43 patients, 33 showed hyperechoic spots amid hypoechoic lesions on T2WI, so did 26 patients on T1WI but the spots were less in quantity than those on T2WI. Twenty-nine patients were found to be complicated with other gynecological conditions, including 15 with endometriosis (chocolate cyst of ovary), 9 with hysteromyoma, 4 with endometrial hyperplasia and 1 with cervical Nabothian cyst. Conclusion:MRI, with its distinct visualization of adenomyotic lesions, can be a very helpful modality in case identificationand localization of the disease, and thus providing important guidance for the treatment.