Magnetic Resonance Imaging with Diffusion Weighted Imaging for Differentiation between Uterine Fibroid and Focal Adenomyosis

Background: Sometimes the imaging characteristics of focal adenomyosis and uterine fibroids overlap, despite the fact that magnetic resonance imaging (MR) is a very accurate noninvasive technique for diagnosing both conditions. The DWI value could offer helpful details for distinguishing between diseases. The function of DWI in the distinction of uterine fibroids and denomyosis is not well studied. There is no pathological evidence to support the diagnosis of fibroid or adenomyosis. Therefore, our goal was to assess how well DWI distinguishes between localized adenomyosis and uterine fibroids using the ADC value. Methods: This cross sectional study included 2 groups of female patients who clinically complained of vaginal bleeding with US findings of suspicious uterine focal lesion and patients previously diagnosed as uterine fibroids and/or focal adenomyosis who presents to radiological department for pelvic MRI, DWI was done for all of them ADC values were calculated for fibroid, focal and diffuse adenomyosis as well as normal myometrium. Results: Adenomyosis lesions (mean 0.96 ± 0.02) demonstrated higher ADC values than hypointense fibroids (mean 0.83 ± 0.03; p < 0.001) but were comparable to submucosal fibroids (mean 0.98 ± 0.17; p = 0.6097). ADC values for focal and diffuse adenomyosis were similar (mean 0.96 ± 0.02 for both). Conclusion: Diffusion-weighted imaging (DWI) with apparent diffusion coefficient (ADC) mapping is a valuable tool in differentiating uterine fibroids from focal adenomyosis.