Adenomyosis

Na Yeon Han, Seung Hyup Kim
In: Gynecologic Imaging · 2026 · pp. 189–215 · doi:10.1007/978-981-95-2427-3_7 · W7131067039
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This paper describes the imaging features, unusual types, and differential diagnoses of adenomyosis, a common uterine disease involving ectopic endometrial tissue and myometrial inflammation.

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This chapter reviews imaging of adenomyosis, focusing on transvaginal ultrasonography as a primary screening tool and MRI as a confirmative diagnostic study. It describes how adenomyosis commonly diffusely involves the myometrium with muscular hypertrophy, but can also appear localized and mimic other uterine lesions such as myoma, endometrial cancer, and myometrial contraction. The chapter emphasizes that because adenomyosis can show varied imaging patterns, it can create diagnostic dilemmas, and it discusses unusual growth patterns and differential diagnoses as limitations that complicate interpretation. Relevance to endometriosis: adenomyosis is discussed as an entity related to endometriosis in the broader context of the chapter’s background pathophysiology (including mention of the endometrial tissue and inflammatory changes that connect to endometriosis-related concepts), though the paper’s main focus is imaging features and differential diagnosis.

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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. Access this chapter Tax calculation will be finalised at checkout Purchases are for personal use only 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 © 2026 Springer Nature Singapore Pte Ltd. About this entry Cite this entry Han, N.Y., KIM, S.H. (2026). Adenomyosis. In: KIM, S.H. (eds) Gynecologic Imaging. Springer, Singapore. https://doi.org/10.1007/978-981-95-2427-3_7 Download citation DOI: https://doi.org/10.1007/978-981-95-2427-3_7 Published: Publisher Name: Springer, Singapore Print ISBN: 978-981-95-2426-6 Online ISBN: 978-981-95-2427-3 eBook Packages: MedicineReference Module Medicine

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