Differential Diagnosis of Uterine Fibroids and Adenomyosis

Akiko Takahata, Sachimi Yamada
In: MRI and CT for Decision-Making in Obstetrics and Gynecology Practice · 2025 · pp. 193–202 · doi:10.1007/978-981-97-5120-4_21 · W4409830745
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This chapter discusses the MRI differential diagnosis of uterine fibroids, which typically appear as low-signal masses on T2WI, and acknowledges their variable appearances.

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This chapter addresses how to differentiate uterine fibroids from other myometrial lesions when imaging shows low signal intensity on T2-weighted imaging, describing typical MRI appearance of leiomyomas as well-defined, distinct low-signal-intensity masses. It also emphasizes that fibroids can show degenerative changes and variants that may sometimes present with high signal intensity on T2WI, and directs readers to another chapter for differential diagnosis of high-signal lesions. A major limitation explicitly noted is that the differential approach is restricted to lesions with low T2WI signal. Relevance to endometriosis: the chapter focuses on adenomyosis versus leiomyoma differential diagnosis with MRI (including citation of prior radiology work on adenomyosis), which is closely related to endometriosis through shared disease entities within the endometriosis-related corpus.

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Abstract

Uterine fibroids (leiomyomas) typically appear as well-defined, distinct low-signal-intensity masses on T2-weighted imaging (T2WI). This article discusses the differential diagnosis of myometrial lesions that present with low signal intensity on T2WI. It should be noted that uterine fibroids can exhibit various degenerative changes and variants, and may sometimes present with high signal intensity on T2WI. For differential diagnosis of lesions showing high signal intensity on T2WI, please refer to a separate chapter. Access this chapter Tax calculation will be finalised at checkout Purchases are for personal use only Similar content being viewed by others

References

Hricak H, et al. Uterine leiomyomas: correlation of MR, histopathologic findings, and symptoms. Radiology. 1986;158:385–91. Mark AS, et al. Adenomyosis and leiomyoma: differential diagnosis with MR imaging. Radiology. 1987;163:527–9. Togashi K, et al. Enlarged uterus: differentiation between adenomyosis and leiomyoma with MR imaging. Radiology. 1989;171:531–4. Togashi K, et al. Adenomyosis: diagnosis with MR imaging. Radiology. 1988;166:111–4. Kataoka ML, et al. MRI of the adenomyotic cyst of the uterus. J Comput Assist Tomogr. 1998;22:555–9. Togashi K, et al. Uterine contractions: possible diagnostic pitfall at MR imaging. J Magn Reson Imaging. 1993;3:889–93. Tamai K, et al. MR imaging findings of adenomyosis: correlation with histopathologic features and diagnostic pitfalls. Radiographics. 2005;25:21–40. Song SE, et al. MR imaging features of uterine adenomyomas. Abdom Imaging. 2011;36:483–8. Takeuchi M, et al. MR imaging findings of uterine adenomatoid tumors. Magn Reson Med Sci. 2024;23:127–35. Yen CF, et al. Successful pregnancies in women with diffuse uterine leiomyomatosis after hysteroscopic management. Fertil Steril. 2007;88:1667–73. Kido A, et al. Diffusely enlarged uterus: evaluation with MR imaging. Radiographics. 2003;23:1423–39. Author information Authors and Affiliations Corresponding author Editor information Editors and Affiliations Rights and permissions Copyright information © 2025 The Author(s), under exclusive license to Springer Nature Singapore Pte Ltd. About this chapter Cite this chapter Takahata, A., Yamada, S. (2025). Differential Diagnosis of Uterine Fibroids and Adenomyosis. In: Matsumura, N., Matsuki, M., Kido, A. (eds) MRI and CT for Decision-Making in Obstetrics and Gynecology Practice. Springer, Singapore. https://doi.org/10.1007/978-981-97-5120-4_21 Download citation DOI: https://doi.org/10.1007/978-981-97-5120-4_21 Published: Publisher Name: Springer, Singapore Print ISBN: 978-981-97-5119-8 Online ISBN: 978-981-97-5120-4 eBook Packages: MedicineMedicine (R0)

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adenomyosis

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Papers in the corpus that this work cites (lower rings, blue) and that cite this one (upper rings, green). Dot size scales with the paper's in-corpus citation count — bigger dot = more influential within the endo/adeno field. Click a dot to open that paper. [ expand to 2 hops ] — adds papers reached through this work's immediate citers/citees. Heavier; up to 60 extra dots.

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