Diffuse adenomyosis with ovarian endometrioma and hematosalpinx
Diagnosis almost certain
Presentation
Chronic pelvic pain.
Patient Data
Age: 45 years
Gender: Female
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The MRI sequences demonstrate:
- enlarged uterus with diffuse thickening of the junctional zone (thickness = 20 mm) displaying an intermediate signal on T1, and low signal on T2 with foci of high signal within (menstrual hemorrhage into the ectopic endometrial tissues), in keeping with diffuse adenomyosis
- small uterine leiomyomas
- left ovarian cystic lesion (30 mm) of high signal on T1, T1 fat sat, and T2 shading with no enhancement in keeping with endometrioma. A Small left ovarian hemorrhagic corpus luteal cyst is also noted (23 mm)
- distended and tortuous left fallopian tube with high T1 and T2 fluid content indicating a hematosalpinx.
Case Discussion
MRI features of diffuse adenomyosis with small intramural leiomyomas, left ovarian endometrioma and hematosalpinx.
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