MR imaging features of uterine adenomyomas

Background To evaluate the magnetic resonance (MR) imaging features of uterine adenomyoma in comparison with histopathologic findings.

MR images of seven patients who had surgically proven uterine adenomyoma were retrospectively reviewed by two radiologists in consensus regarding the morphologic appearance, including tumor size, location, margin, presence of concomitant adenomyosis, presence and signal intensity of cavity within tumor, and signal intensity and enhancement pattern of solid portion of tumor. MR imaging findings were correlated with histopathologic findings.

Tumor location was submucosal in three cases, subserosal in two, and mixed mural/subserosal in two. All tumors were well circumscribed on T2-weighted images and contrast-enhanced fat-suppressed T1-weighted images. In six cases, well defined cavities of high signal intensity, which reflected hemorrhagic cavities pathologically, were demonstrated within the tumors on T1-weighted images. Concomitant adenomyosis was observed in five cases. Solid portion of all tumors except hemorrhagic cavities exhibited iso-signal intensity on T1-weighted images, various signal intensity on T2-weighted images, and homogeneous enhancement on contrast-enhanced fat-suppressed T1-weighted images in five cases.

When MR imaging shows a well circumscribed mass with hemorrhagic cavities of high signal intensity on T1-weighted images and concomitant adenomyosis in the uterus, adenomyoma should be considered in the differential diagnosis. Similar content being viewed by others

Longacre TA, Chung MH, Rouse RV, Hendrickson MR (1996) Atypical polypoid adenomyofibromas (atypical polypoid adenomyomas) of the uterus. A clinicopathologic study of 55 cases. Am J Surg Pathol 20:1–20 Gilks CB, Clement PB, Hart WR, Young RH (2000) Uterine adenomyomas excluding atypical polypoid adenomyomas and adenomyomas of endocervical type: a clinicopathologic study of 30 cases of an underemphasized lesion that may cause diagnostic problems with brief consideration of adenomyomas of other female genital tract sites. Int J Gynecol Pathol 19:195–205 Tahlan A, Nanda A, Mohan H (2006) Uterine adenomyoma: a clinicopathologic review of 26 cases and a review of the literature. Int J Gynecol Pathol 25:361–365 Tamai K, Togashi K, Ito T, et al. (2005) MR imaging findings of adenomyosis: correlation with histopathologic features and diagnostic pitfalls. Radiographics 25:21–40 Ozaki K, Gabata T, Matsui O, et al. (2008) MR imaging of an adenomyoma of the uterus. Eur J Radiol Extra 66:e109–e112 Yamashita Y, Torashima M, Hatanaka Y, et al. (1995) MR imaging of atypical polypoid adenomyoma. Comput Med Imaging Graph 19:351–355 Kitajima K, Imanaka K, Kuwata Y, Hashimoto K, Sugimura K (2007) Magnetic resonance imaging of typical polypoid adenomyoma of the uterus in 8 patients: correlation with pathological findings. J Comput Assist Tomogr 31:463–468 Lee KR (1993) Atypical polypoid adenomyoma of the endometrium associated with adenomyomatosis and adenocarcinoma. Gynecol Oncol 51:416–418 Connors AM, deSouza NM, McIndoe GA (2003) Adenomyoma mimicking an aggressive uterine neoplasm on MRI. Br J Radiol 76:66–68 Örs F, Lev-Toaff AS, Bergin D (2009) Cystic adenomyoma: transvaginal ultrasound and MRI findings. Anatol J Clin Invest 3:68–70 Silverberg SG (1975) Adenomyomatosis of endometrium and endocervix—a hamartoma. Am J Clin Pathol 64:192–199 Byun JY, Kim SE, Choi BG, et al. (1999) Diffuse and focal adenomyosis: MR imaging findings. Radiographics 19:S161–S170 Grimbizis GF, Mikos T, Zepiridis L, et al. (2008) Laparoscopic excision of uterine adenomyomas. Fertil Steril 89:953–961 Author information Authors and Affiliations Corresponding author Rights and permissions About this article Cite this article Song, S.E., Sung, D.J., Park, B.J. et al. MR imaging features of uterine adenomyomas. Abdom Imaging 36, 483–488 (2011). https://doi.org/10.1007/s00261-010-9640-6 Published: Issue date: DOI: https://doi.org/10.1007/s00261-010-9640-6