Adenomyosis on MRI is best characterised by which finding?

• A Bright T2 signal within the junctional zone > 12 mm
• B Thickened junctional zone > 12 mm with low T2 signal and high T2 foci within ✓
• C Subendometrial haemosiderin deposits on T1 imaging
• D Multiple septated cysts within the myometrium on T2

Explanation

MRI is the gold standard for adenomyosis diagnosis. The junctional zone (inner myometrium) normally measures < 8 mm on T2-weighted MRI. Adenomyosis is characterised by a thickened junctional zone > 12 mm (8–12 mm is indeterminate) appearing as low T2 signal (from smooth muscle hypertrophy) with interspersed high T2 signal foci (representing ectopic endometrial glands and cystic changes). T1-bright foci within adenomyosis represent haemorrhagic foci. Multiple septated cysts describe a different entity.

Reference: Shaw's Textbook of Gynaecology, 17th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.