Regarding adenomyosis, which MRI feature is MOST specific for diagnosis?
- A Uterine size >14 cm on T2-weighted MRI
- B Junctional zone thickness ≥12 mm on T2-weighted MRI ✓
- C Hyperintense foci within the myometrium on T2-weighted MRI
- D Diffuse uterine enlargement with globular configuration
Correct answer: B. Junctional zone thickness ≥12 mm on T2-weighted MRI
Explanation
Junctional zone (JZ) thickness on T2-weighted MRI is the most specific and sensitive marker for adenomyosis. A JZ thickness ≥12 mm (or JZ max–min ratio >40%) has the highest diagnostic accuracy. The JZ represents the inner myometrial layer (hypointense on T2). Hyperintense foci within low-signal myometrium also suggest ectopic glands/hemorrhage, but JZ thickening ≥12 mm is the established diagnostic criterion. Uterine enlargement and globular configuration are supportive but nonspecific.
Reference: Shaw's Textbook of Gynaecology, 17th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
Written and medically reviewed by the StethoPrep medical team.