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Junctional zone (uterus)

Last revised by Henry Knipe ◉ on 31 Oct 2024

Citation, DOI, disclosures and article data

Citation:

Knipe H, Verikios N, Weaver P, et al. Junctional zone (uterus). Reference article, Radiopaedia.org (Accessed on 14 Jan 2025) https://doi.org/10.53347/rID-17179

DOI:

https://doi.org/10.53347/rID-17179

Permalink:

https://radiopaedia.org/articles/17179

rID:

17179

Article created:

23 Mar 2012, Yuranga Weerakkody ◉

Disclosures:

At the time the article was created Yuranga Weerakkody had no recorded disclosures.

View Yuranga Weerakkody's current disclosures

Last revised:

31 Oct 2024, Henry Knipe ◉

Disclosures:

At the time the article was last revised Henry Knipe had the following disclosures:

Micro-X Ltd, Shareholder (past)

These were assessed during peer review and were determined to not be relevant to the changes that were made.

View Henry Knipe's current disclosures

Revisions:

16 times, by 12 contributors - see full revision history and disclosures

Systems:

Gynaecology

Sections:

Anatomy

Tags:

cases, snippet, case2

Synonyms:

Junctional zone of the uterus
Juntional zone in pelvic MRI imaging
Inner myometrium
Juntional zone of uterus
Stratum subvasculare

The junctional zone, also known as the inner myometrium or stratum subvalvular, is a layer of the uterine myometrium and is an important imaging feature in pelvic MRI.

Radiographic features

Ultrasound

At times, it can also be seen on ultrasound as a slightly more hypoechogenic layer between the endometrium and deeper myometrium.

MRI

Its intact state is usually visible on MRI as a low T2 signal layer beneath the endometrium. This low signal intensity is thought to be from closely packed smooth muscle cells arranged concentrically around the uterine cavity, with a relative paucity of water and extracellular matrix.

Related pathology

Disruption or alteration of the junctional zone is seen in various pathologies:

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
feature of myometrial invasion, e.g. fro endometrial carcinoma, invasive mole
uterine lymphoma is not thought to disrupt the junctional zone ⁷

Some research also emphasizes the use of the junctional zone as a predictor for implantation failure following in vitro fertilisation (IVF) ².

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