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Classic Adenomyosis on MRI – T2 Cysts

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Our next case, another pelvic MRI,

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which shows some classic findings of adenomyosis.

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We'll start with our T2, and you can see

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this was pretty marred by breathing artifacts

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here, all of our artifact right here

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that's occurring, but it's still diagnostic.

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So, your pubic symphysis here, sacrum back

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here, spinal canal back here, bladder up

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here, urethra is going to be somewhere

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in here, vagina somewhere here, rectum

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coming down here, anal canal, just to again

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give you an idea exactly where we are.

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Cervix in this case is going to be

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back here, we're a little bit off

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axis which can happen with the uterus.

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Here's your nice thin endometrium in

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this particular case, and then we have

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a very large globular uterus, right?

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And it's very asymmetric.

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Anteriorly, it looks pretty good.

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We don't really have a T2 dark, thick,

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and junctional zone per se in this person.

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It's really hard even to find it discreetly,

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but what we do have is we have this sort

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of ill-defined structure in the posterior

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uterus that has multiple T2 bright foci,

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28 00:00:59,665 --> 00:00:59,804

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poorly defined walls here.

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It doesn't look like a fibroid necessarily.

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It's not that T2 dark.

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They're usually pretty T2 dark.

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And would have well-defined walls,

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which this doesn't have, so this is a pretty

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classic T2 bright foci of adenomyosis.

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Usually sagittal, I like that the best

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for looking for those particular entities,

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but in this case, you can see it too.

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Like it's very nicely shown on

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the actual image, so again, cervix

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down here, endometrium coming up.

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You have a really large globular uterus, right?

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That's really rounded like a globe.

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And you can see here's the endometrium here.

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And this just ill-defined structure back

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here, no well-defined borders, a little bit

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darker than the rest of the myometrium with

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T2 bright foci scattered throughout it.

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This is classic, classic adenomyosis,

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asymmetric, elliptical shape, poorly defined

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borders, and in this case, somewhat focal.

Report

Faculty

Kathryn McGillen, MD

Assistant Professor of Radiology, Medical Director of Ultrasound

Penn State University Milton S Hershey Medical Center

Tags

Vascular

Uterus

MRI

Idiopathic

Gynecologic (GYN)

Body

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