Imaging Spectrum of Typical and Atypical Adenomyosis

Area of Science:

• Radiology and Imaging
• Gynecologic Imaging
• Women's Health

Background:

• Adenomyosis, endometrial tissue in the myometrium, is common in reproductive-aged women.
• Current imaging classification lacks consensus, especially for MRI.
• Diverse presentations complicate diagnosis and management.

Purpose of the Study:

• To review and illustrate typical and atypical adenomyosis imaging features.
• To provide guidance for differentiating adenomyosis from other uterine conditions.
• To enhance diagnostic accuracy and clinical management.

Main Methods:

• Review of imaging findings for adenomyosis at ultrasound (US) and MRI.
• Inclusion of focal, diffuse, adenomyomas (solid/cystic), polypoid, pregnancy-associated, and malignant cases.
• Discussion of differential diagnoses including leiomyomas and endometriosis.

Main Results:

• Detailed examination of diverse adenomyosis manifestations on US and MRI.
• Highlighting challenges in diagnosing atypical presentations.
• Providing practical tips for differential diagnosis.

Conclusions:

• Standardized imaging descriptors are needed for adenomyosis, particularly for MRI.
• Familiarity with typical and atypical imaging is crucial for accurate diagnosis.
• This review aids radiologists in distinguishing adenomyosis and optimizing patient care.