Learning objectives
To illustrate normal uterine anatomy and review the MRI uterine protocol.
To illustrate the radiographic findings for diagnosis of different forms of adenomyosis: focal and diffuse.
To discuss possible diagnostic errors and differential diagnosis.
Background
Adenomyosis is a benign disease of the uterus characterized by ectopic endometrial tissue present in the myometrium.
The clinical diagnosis of adenomyosis is difficult because of nonspecific clinical presentation and the frequent coexistence of other pelvic diseases.
MRI is an effective technique for diagnosis,
it can be differentiated from other uterine pathology and help to plan treatment.
CLINICAL PRESENTATION:
Usually adenomyosis affects premenopausal multiparous women.The most frequent symptoms are menhorragia,
dysmenorrhea and dispareunia,
however,
between 3% and 35% of patients are asymptomatic.
It has long...
Findings and procedure details
OPTIMISED MRI PROTOCOL
WHEN?
It is important to perform the MRI study avoiding the menstrual phase to differentiate the physiologic thickening of the JZ during menstruation from the diagnosis of adenomyosis.
To optimisate the MRI study it is should be performed in the late proliferative- secretory phase of the menstrual cycle.
HOW?
T2WI: It should be performed sagital T2WI image of the pelvis,
it can be included an axial plane slanted perpendicular to the line of the miometrium in order to assess properly the thickness...
Conclusion
MRI is an effective non-invasive technique for the diagnosis of adenomyosis,
it can differentiate from other uterine pathology and it can help to plan the treatment.
It is important to use an appropiate protocol,
to correlate with the menstrual cycle and to know the MRI appearance of the different forms of adenomyosis for an accurate diagnosis.
Personal information
M.
Boada Ordis.
MRI Department - CLÍNICA GIRONA.
Universitat de Girona UDG.
GIRONA - SPAIN
[email protected]
References
-Naftalin J,
Hoo W,
Paterman K,
Mavrelos D,
Holland T,
Jurkovic D.
How common is adenomyosis? A prospective study of prevalence using transvaginal ultrasound in a gynaecology clinic.
Human Reprod.2012 Dec;27(12):3432-9.
doi: 10.1093/humrep/des332.
Epub 2012 Sep 20.
-Sebastiano Campo,
Vincenzo Campo,
and Giuseppe Benagiano.
Infertility and Adenomyosis.
Obstetrics and Gynecology International.
Volume 2012.
article ID 786132,
8 pages doi: 10.1155/2012/786132.
-Yang Q,
Zhang LH,
Su J,
Liu J.
The utility of diffusion-weighted MR imaging in differentiation of uterine adenomyosis and leiomyoma.
Eur J Radiol.2011 Aug;79(2):e47-51....
