الفهرس 
Gross and MRI anatomy of the uterusOnly 14 pages are availabe for public view
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Abstract
Adenomyosis is a common non neoplastic gynecologic disease characterized by the presence of ectopic endometrium within the myometrium affecting multiparous, premenopausal women over 30 years of age.
- The common symptoms include dysmenorrhea, menorrhagia, and abnormal uterine bleeding, but these do not allow diagnosis. Therefore, imaging plays an important role because establishment of the correct preoperative diagnosis is critical to avoid unnecessary intervention.
- Magnetic resonance (MR) imaging is a highly accurate non invasive modality for diagnosis of adenomyosis. The reason for this high accuracy of MRI is its ability to visualize the zonal anatomy of the uterus through its superior soft tissue contrast and multiplanar capability. Various MRI manifestations including both direct and indirect signs helps to easily diagnose the presence of adenomyosis. The most important of which is the thickness of the junctional zone with threshold of 12 mm thickness, at this level or above, the diagnosis of adenomyosis can be established.
- On T2-weighted magnetic resonance (MR) images, typical adenomyosis appears as an ill-demarcated low signal intensity
Summary and Conclusion
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lesion with uterine enlargement and is diagnosed when the altered junctional zone thickness is greater than 12 mm. However, there are many entities that may resemble the MR imaging appearance of adenomyosis. Problem solving MR imaging techniques used in diagnosis of adenomyosis include diffusion-weighted imaging, susceptibility-weighted imaging, MR spectroscopy, cine MR imaging, high-resolution MR imaging at 3T and post contrast imaging.
- Transabdominal sonography (TAS) or transvaginal sonography (TVS) is commonly used as the initial imaging modality. TAS does not allow reliable diagnosis of adenomyosis or consistent differentiation from leiomyomas because of its limited spatial resolution. TVS, which can improve spatial resolution with its higher frequency, is known to be accurate in diagnosing adenomyosis, but it actually has limitations in tissue characterization
- So, as diagnosis of adenomyosis depends greatly upon the identification and evaluation of the zonal anatomy, and since MRI was the first imaging technique to reveal the junctional zone and remains the standard tool for its evaluation, MRI remains the golden modality for diagnosis of adenomyosis.