Adenomyosis on MRI

Case contributed by Alexandra Stanislavsky
Diagnosis almost certain

Presentation

Disordered uterine bleeding and mildly elevated CA-125

Patient Data

Age: 40 years
Gender: Female
mri

The uterus is enlarged, with thickening and ill definition of the junctional zone. Multiple small T2 hyperintense foci are present throughout the myometrium, many of which have high T1 signal.  The appearance is in keeping with diffuse adenomyosis.  Several small mural fibroids are also present. Subseptate uterine morphology.

Case Discussion

This case demonstrates diffuse adenomyosis of the uterus.  The high T1 foci indicate menstrual hemorrhage into the ectopic endometrial tissue.

Adenomyosis can be associated with elevation of CA-125.

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