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[edit] Discussion of Adenomyosis

  • Characterized by benign invasion of endometrium into the myometrium with adjacent smooth muscle hyperplasia.
  • The ectopic endometrial glands within adenomyosis are generally do not respond to cyclic ovarian hormones, unlike those of endometriosis.

  • Adenomyosis occurs mainly in multiparous, premenopausal women.
  • Common symptoms include dysmenorrhea, menorrhagia, and abnormal uterine bleeding (nonspecific symptoms).

  • Treatment for adenomyosis depends on the patient’s symptoms, age, and desire for future fertility.
  • The definitive treatment is hysterectomy.
  • If symptomatic relief can be obtained with nonsteroidal anti-inflammatory drugs, or if the patient is perimenopausal with anticipated cessation of ovarian function, conservative therapy is warranted.

[edit] Imaging Findings for Adenomyosis

[edit] US

  • Typical appearances of adenomyosis at transvaginal ultrasound include poorly marginated hypoechoic and heterogeneous areas within the myometrium, myometrial cysts, and a globular or enlarged uterus with asymmetry.

[edit] MRI

  • Adenomyosis appears as either diffuse or focal thickening (greater than 12 mm )of the junctional zone forming an ill-defined area of low signal intensity, occasionally with embedded bright foci on T2-weighted images.
  • Histologically, areas of low signal intensity correspond to smooth muscle hyperplasia, and bright foci on T2-weighted images correspond to islands of ectopic endometrial tissue and cystic dilatation of glands.

[edit] Images

Patient #1: US, CT and MR images demonstrate adenomyosis

Patient #2: US and MR images demonstrate adenomyosis

[edit] See Also

[edit] External Links

[edit] References for Adenomyosis