Presentation
Vaginal bleeding.
Patient Data
Age: 50 years
Gender: Female
From the case:
Focal uterine adenomyosis
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The uterus is enlarged with focal thickening of the endometrium-myometrium junctional zone at the corporeofundal region (thickness=46 mm), seen as an ill-defined area within the myometrium of intermediate signal on T1 and T2 with foci of high signal (ectopic endometrial tissue within the myometrium). A mass effect is noted on the endometrial cavity which contains hyperintense fluid.
Small Nabothian cysts are noted.
Case Discussion
MRI of features most consistent with focal adenomyosis.
The main differential diagnosis is a uterine leiomyoma:
- peripheral displacement of the vessels on color Doppler
- +/- calcification.