MRI is the modality of choice to diagnose and characterise adenomyosis, and T2 weighted images (sagittal and axial) are most useful. MRI has a sensitivity of 78-88% and a specificity of 67-93%
The most easily recognised feature is thickening of the junctional zone of the uterus to more than 12 mm, either diffusely or focally (normal junctional zone measures no more than 5 mm) 5.
- T2
- typically a region of adenomyosis appears as an ill-defined ovoid/diffuse region of thickening, often with small high T2 signal regions representing small regions of cystic change
- the region may also have a striated appearance 5
- T1
- foci of high T1 signal are often seen, indicating menstrual haemorrhage into the ectopic endometrial tissues 7
- T1 C+ (Gd)
- contrast enhanced MR evaluation is usually not indicated for evaluation of adenomyosis, however, if performed, it shows enhancement of the ectopic endometrial glands
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This blog explained pelvic MRI for adenomyosis in an easy-to-understand way. Great info!
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