IMAGING FEATURES OF ADENOMYOSIS

This review focuses on non-invasive imaging techniques that have prove n useful in diagnosing adenomyosis, including hysterosalpingography, t ransabdominal and endovaginal ultrasound, as well as magnetic resonanc e imaging. An understanding of the histopathological features of this disease is crucial when attempting to interpret the associated imaging findings, The muscular hyperplasia accompanying the heterotopic endom etrial tissue actually produces the typical gross appearance of adenom yosis and corresponds to areas of decreased echogenicity or signal int ensity on ultrasound and magnetic resonance imaging respectively. The heterotopic endometrial tissue also contributes to the imaging appeara nce of adenomyosis, and with the advent of high resolution imaging tec hniques, these changes are being detected with increasing frequency, i ncluding the presence of myometrial nodules, linear striation, poor de finition and nodularity of the endo-myometrial junction, pseudowidenin g of the endometrium, and myometrial cysts or haemorrhagic foci. The p urpose of this review is to (i) present the spectrum of imaging findin gs of adenomyosis, (ii) illustrate potential pitfalls in diagnosis and (iii) review the accuracy and role of currently available noninvasive imaging techniques.