Presentation
Had cesarian section 5 years ago, complaining of cyclic pelvic pain with palpable nodular mass.
Patient Data
The uterus is diffusely enlarged with thickening of the junctional zone from 20 mm to 25 mm, containing multiple foci of high T1WI and T2WI signal.
A nodular mass is noted within the right rectus muscle, composed of punctate foci of very high signal areas on T1WI, inhomogeneous high signal on T2WI, high signal on DWI with low ADC. The postcontrast sequences show a minimal enhancement.
Small ovarian follicles are noted with minimal effusion in Douglas pouch.
Case Discussion
MRI features are characteristic of diffuse adenomyosis with scar endometriosis.