Radiology, Vol 163, 527-529, Copyright © 1987 by Radiological Society of North America
Adenomyosis and leiomyoma: differential diagnosis with MR imaging
AS Mark, H Hricak, LW Heinrichs, MR Hendrickson, ML Winkler, JA Bachica and JE Stickler
To assess the capability of magnetic resonance (MR) imaging to enable
differentiation of adenomyosis from leiomyoma, a prospective study was
performed in 21 premenopausal patients with a strong clinical suggestion of
adenomyosis. Histologic findings from hysterectomy (19 patients) and biopsy
specimens (two patients) showed that eight patients had adenomyosis (three
focal, five diffuse) and 12 had leiomyomas (five of the 12 also had
microscopic foci of adenomyosis); one patient had a normal uterus. All
eight cases of adenomyosis were correctly diagnosed from MR images. On
T2-weighted MR images, diffuse adenomyosis appeared as a thickening of the
junctional zone, whereas focal adenomyosis appeared as a
low-signal-intensity mass poorly marginated from the adjacent myometrium.
Ten of the 12 leiomyomas were correctly diagnosed from MR images. In the
other two cases of leiomyoma, differentiation between focal adenomyosis and
leiomyoma was not possible. Microscopic foci of adenomyosis were not
demonstrated with MR imaging.
