Learning objectives
To showthe usual and unusual MRI findings for the diagnosis of adenomyosis.
To describethe different forms of presentation of adenomyosis.
To describetheusefullMRI sequences for the correct diagnosis of adenomyosis.
To describethe most common associated pathologies and differential diagnoses of adenomyosis.
Background
Benignuterine pathology.
Infiltration of the basal endometrium into the myometrium with hypertrophy and hyperplasia of the smooth muscle surrounding the islands of endometrial tissue.
Presenceof ectopic endometrial glands and stroma within the myometrium.
Non-specificclinical manifestations.
Frequentlycoexists with other pelvicdiseases(endometriosis – myomatosis).
Findings and procedure details
AETHIOLOGY
Stillnot fullyunderstood.
Varioustheories have beenproposed:
Exposureto aestrogen.
Parity.
Prioruterinesurgery.
Most frequently in postmenopausal women,
although evidence points that beginsduring women’s fertile age.
Rare inadolescence (except for cystic adenomyosis).
DIAGNOSIS
Clincical diagnosis is difficult (non specific manifestations)
1/3 Asymptomatic.
2/3 Menorrhagia,
dysmenorrhea,
pelvic pain and uterine enlargement.
TVUSandMRIare the main imaging tools.
MRI diagnostic accuracy: 85%.
Thethickness of the junctional zone (JZ) isthe most frequent MRI criterionfor thediagnosis.
JZ thickness > 12 mm is highly predictiveofadenomyosis.
JZthickness< 8 mm excludes the disease.
JZthickness between 8-12mm...
Conclusion
As clinical diagnosis of Adenomyosis is difficult,
it is important to be aware about the usual and unusual MRI findings of this disease in order to make its correct diagnosis,identify forms of presentation,
differentiate it from others pelvic entities and recognize associated pathologies.
MRI is the gold standard imaging study due to its high diagnostic accuracy (85%).
Personal information
DR.
JORGE A.
MURILLO
Radiologist,
Department of Radiology,
Hospital Escuela Universitario,
Blv.
Suyapa,
Tegucigalpa Honduras.
Cel.+54 9 341 217 9824
+504 9992 3040
Email:
[email protected]
DRA.
DANIELA STOISA
Radiologist,
Urogenital radiology Section,
Department of Radiology,
Grupo Medico Oroño,
Blv Oroño 1515,
Rosario,
Argentina.
Email:
[email protected]
DR.
ROBERTO VILLAVICENCIO
Radiologist,
Department of Radiology,
Grupo Medico Oroño,
Blv Oroño 1515,
Rosario,
Argentina.
FUNDACION DR.
J.R VILLAVICENCIO
Grupo Oroño,
Alvear 854/S2000QGB,
Rosario,
Argentina.
Telfax:+54 0341 4490152Cel:+54 0341 153 929603
Email:
[email protected]
www.villavicencio.org.ar
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