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.
 Imaging Findings for Adenomyosis
- 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.
- 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.
Patient #1: US, CT and MR images demonstrate adenomyosis
Patient #2: US and MR images demonstrate adenomyosis
 See Also
 External Links
 References for Adenomyosis
- Ken Tamai, Kaori Togashi, Tsuyoshi Ito, Nobuko Morisawa, Toshitaka Fujiwara, and Takashi Koyama. MR Imaging Findings of Adenomyosis: Correlation with Histopathologic Features and Diagnostic Pitfalls. RadioGraphics 2005 25: 21-40.