Adenomyosis

Na Yeon Han, Seung Hyup Kim
Gynecologic Imaging · 2025 · pp. 1–27 · doi:10.1007/978-981-99-2955-9_7-1 · W4417496323
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This chapter describes adenomyosis, a uterine disease characterized by ectopic endometrial tissue and myometrial inflammation, detailing its imaging features, unusual presentations, and differential diagnoses.

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This paper/chapter reviews adenomyosis as a nonneoplastic uterine disorder composed of ectopic endometrial tissue with associated inflammatory myometrial change, focusing on imaging rather than original experimental data. It explains how transvaginal ultrasonography is commonly used for screening while MRI is presented as a confirmative diagnostic study, noting that adenomyosis can diffusely involve the myometrium with muscular hypertrophy or appear localized and mimic other uterine lesions such as fibroids, endometrial cancer, or contraction. A major caveat is that adenomyosis shows varied imaging features that can create diagnostic dilemmas and require discussion of differential diagnoses and unusual growth patterns. Relevance to endometriosis: the chapter specifically frames adenomyosis in relation to ectopic endometrial tissue and includes referenced work on the pathogenesis of adenomyosis vis-à-vis endometriosis and on MRI relationships between adenomyosis and endometriosis phenotypes, though its main focus is imaging features and differential diagnosis for adenomyosis.

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Abstract

Adenomyosis is a common nonneoplastic uterine disease pathologically composed of ectopic endometrial tissues and a myometrial inflammatory change. Transvaginal ultrasonography is used as a primary imaging modality for screening adenomyosis. MRI is considered a confirmative study for diagnosing adenomyosis. Frequently, adenomyosis diffusely involves myometrium, resulting in muscular hypertrophy. Less frequently, the lesion can manifest a localized form that resembles various uterine lesions including myoma, endometrial cancer, and myometrial contraction. Since adenomyosis can show various imaging features, it may cause a diagnostic dilemma. This chapter will describe imaging features of adenomyosis, unusual types or growth patterns of adenomyosis, and differential diagnoses. Similar content being viewed by others

References

Agostinho L, Cruz R, Osório F, et al. MRI for adenomyosis: a pictorial review. Insights Imaging. 2017:8(6):549–556. https://doi.org/10.1007/s13244-017-0576-z. Celli V, Dolciami M, Ninkova R, et al. MRI and adenomyosis: what can radiologists evaluate? Int J Environ Res Public Health. 2022;19(10):5840. https://doi.org/10.3390/ijerph19105840. Chapron C, Vannuccini S, Santulli P, et al. MRI of adenomyosis: where are we today? Can Assoc Radiol J. 2023;74(1):58–68. https://doi.org/10.1177/08465371221114197. Cunningham RK, Horrow MM, Smith RJ, et al. Adenomyosis: a sonographic diagnosis. Radiographics. 2018;38(5):1576–1589. https://doi.org/10.1148/rg.2018180080. Guo SW, Mao X, Ma Q. The pathogenesis of adenomyosis vis-à-vis endometriosis. J Clin Med. 2020;9(2):485. https://doi.org/10.3390/jcm9020485. Kishi Y, Suginami H, Kuramori R, et al. Four subtypes of adenomyosis assessed by magnetic resonance imaging and their specification. Am J Obstet Gynecol. 2012;207(2):114.e1–7. https://doi.org/10.1016/j.ajog.2012.06.027. Novellas S, Chassang M, Delotte J, et al. MRI characteristics of the uterine junctional zone: from normal to the diagnosis of adenomyosis. AJR Am J Roentgenol. 2011;196(5):1206–1213. https://doi.org/10.2214/AJR.10.4877. Song SE, Sung DJ, Park BJ, et al. MR imaging features of uterine adenomyomas. Abdom Imaging. 2011;36(4):483–488. https://doi.org/10.1007/s00261-010-9640-6. Takeuchi M, Matsuzaki K. Adenomyosis: usual and unusual imaging manifestations, pitfalls, and problem-solving MR imaging techniques. Radiographics. 2011:31(1):99–115. https://doi.org/10.1148/rg.311105110. Zhang T, Sun Y, Gong Y, et al. Relationship between the magnetic resonance imaging appearance of adenomyosis and endometriosis phenotypes. Hum Reprod. 2017;32(7):1393–1401. https://doi.org/10.1093/humrep/dex088. Competing Interest Declaration The author(s) has no competing interests to declare that are relevant to the content of this manuscript. Author information Authors and Affiliations Corresponding author Editor information Editors and Affiliations Section Editor information Rights and permissions Copyright information © 2025 Springer Nature Singapore Pte Ltd. About this entry Cite this entry Han, N.Y., Kim, S.H. (2025). Adenomyosis. In: KIM, S.H. (eds) Gynecologic Imaging. Springer, Singapore. https://doi.org/10.1007/978-981-99-2955-9_7-1 Download citation DOI: https://doi.org/10.1007/978-981-99-2955-9_7-1 Received: Accepted: Published: Publisher Name: Springer, Singapore Print ISBN: 978-981-99-2955-9 Online ISBN: 978-981-99-2955-9 eBook Packages: Living Reference MedicineReference Module Medicine

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