On T2-weighted MRI, adenomyosis characteristically shows which of the following features besides junctional zone thickening?

• A Diffuse low-signal intensity throughout the entire myometrium with loss of zonal anatomy
• B High-signal-intensity myometrial cysts (small punctate bright foci) within thickened junctional zone ✓
• C Well-circumscribed rounded mass with peripheral low-signal pseudocapsule
• D Enhancing endometrial mass with irregular margins invading the outer myometrium

Explanation

On T2-weighted MRI, adenomyosis shows junctional zone thickening (>12 mm) with characteristic high-signal-intensity myometrial cysts (small punctate bright foci representing ectopic endometrial glands/hemorrhage). Option A describes diffuse leiomyomatosis or normal variant. Option C describes a fibroid (leiomyoma). Option D describes endometrial carcinoma with myometrial invasion.

Reference: Diagnostic Imaging: Obstetrics, 4th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.