The utility of low field MRI for diagnosing uterine leiomyoma and adenomyosis

Objective to analyze the MRI findings of uterine leiomyoma and adenomyosis and to evaluate their value in the diagnosis of the two diseases.Methods MRI data of 25 patients with surgically and pathologically proved uterine leiomyoma and adenomyosis were analyzed retrospectively.Results Among 16 patients with uterine leiomyoma,total 24 lesions were detected by MRI,which were hypointensity on T1WI and were difficult of resolution;on T2WI,the lesions were hypointensity,hyperintensity or heterogeneous signals;the most lesions had encapsulated membrane and well-defined margin surrounded by low or high signal circles;the lesions were more or less enhanced after the administration of contrast medium.Among 7 patients with adenomyosis'diffuse and local lesions were found in 5 and 2 case,respectively,which were non-homogeneous signals on T1WI and T2WI.The diffuse or irregular thickening of the junctional zone visible on T2WI could be considered to have diagnostic specificity;the lesions lacked encapsulated membrane and were ill-defined margin with surrounding tissues;the lesions were not obvious enhancement on enhanced images,which were isointensity or hypointensity.The remainder two cases were coexistence of uterine leiomyoma and adenomyosis.T2WI and contrast-enhanced scanning were helpful to visualize and to differentiate the two diseases.One patient with uterine leiomyoma was misdiagnosed as adenomyosis,while one patient with adenomyosis was misdiagnosed as uterine leiomyoma.The sensitivity and accuracy of MRI for the two diseases was 100% and 92%,respectively.Conclusion Selecting the proper MRI sequence and modality is very important to differentiate uterine leiomyoma from adenomyosis.