Adenomyosis – Teaching Points
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Okay, so to wrap up our adenomyosis lesson,
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a few teaching points to consider whenever
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you're looking for this diagnosis in a patient.
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Just remember, it really does have a
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variable appearance on ultrasound and MRI.
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It may have one of the features,
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it may have more of the features.
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Easier to diagnose when it has more than
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one feature, of course, but it's also wise
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to suggest that even if you only see one or
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two, even if you have to hedge a little bit.
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So things that you're looking for,
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you're looking for echogenic or cystic
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foci or striations emanating from
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that endometrium into the myometrium.
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That's the ultrasound appearance.
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The correlate on MRI are going to be
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T2 bright foci or little striations.
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You're going to look for poorly defined
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borders if it's more of an almost sort of
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mass-like structure right there, and that's
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going to separate it from the fibroid.
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That goes for both ultrasound and
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for MRI, poorly defined borders.
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Often on MRI, an adenomyoma specifically
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may be ovoid in shape as well as opposed
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to fibroids which tend to be fairly round.
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And then lastly, you want
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to consider vascularity.
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Those penetrating vessels on color Doppler,
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not always present, but when they are, you can
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be pretty sure you're looking at adenomyosis.
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That's going to be different than a fibroid.
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We're going to have more of a
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circumferential pattern of the vascularity.
Kathryn McGillen, MD
Assistant Professor of Radiology, Medical Director of Ultrasound
Penn State University Milton S Hershey Medical Center
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