Junctional zone is a region representing the inner myometrium and is a very important imaging feature in pelvic MR imaging for interpretation of various pathologies. In its intact state, it is usually visualised as a low T2 signal layer beneath the endometrium.
This low signal intensity is thought to be from closely packed compact smooth muscle cells with little extracellular matrix and water content.
Disruption or alteration of the junctional zone with various pathological conditions.
uterine adenomyosis: makes the junctional zone thicker and hazy
- a junctional zone of <8 mm is considered unlikely to represent adenomyosis 3
- a junctional zone of >12 mm very likely represents adenomyosis 3
- as a feature of myometrial invasion with endometrial carcinoma
- as a feature of myometrial invasion by an invasive mole in the spectrum of gestational trophoblastic disease
- uterine lymphoma is not thought to disrupt the junctional zone 7
Some research also emphasises the use of the junctional zone as a predictor for implantation failure after in vitro fertilisation 2.
- 1. Novellas S, Chassang M, Delotte J et-al. MRI characteristics of the uterine junctional zone: from normal to the diagnosis of adenomyosis. AJR Am J Roentgenol. 2011;196 (5): 1206-13. doi:10.2214/AJR.10.4877 - Pubmed citation
- 2. Maubon A, Faury A, Kapella M et-al. Uterine junctional zone at magnetic resonance imaging: a predictor of in vitro fertilization implantation failure. J. Obstet. Gynaecol. Res. 2010;36 (3): 611-8. doi:10.1111/j.1447-0756.2010.01189.x - Pubmed citation
- 3. Hamm B, Forstner R, Beinder E et-al. MRI and CT of the Female Pelvis. Springer Verlag. (2006) ISBN:3540222898. Read it at Google Books - Find it at Amazon
- 4. Reimer P, Parizel PM, Meaney JF et-al. Clinical MR Imaging, A Practical Approach. Springer Verlag. (2010) ISBN:3540745017. Read it at Google Books - Find it at Amazon
- 5. Zagoria RJ. Genitourinary radiology, the requisites. Mosby Inc. (2004) ISBN:0323018424. Read it at Google Books - Find it at Amazon
- 6. Reimer P, Parizel PM, Meaney JF et-al. Clinical MR Imaging, A Practical Approach. Springer Verlag. (2010) ISBN:3540745017. Read it at Google Books - Find it at Amazon
- 7. Kim YS, Koh BH, Cho OK et-al. MR imaging of primary uterine lymphoma. Abdom Imaging. 22 (4): 441-4. Abdom Imaging (link) - Pubmed citation