Focal adenomyosis
Ovarian
endometrioma: diagnostic mimickers in MRI. A hypointense lesion is noted in the posterior wall of the uterus distinct from the junctional zone (yellow arrow). Also note multiple tiny T2 hyperintense foci within the lesion.
Focal adenomyosis is a morphological subtype of adenomyosis.
Terminology
Some authors regard this term synonymous with an adenomyoma.
Epidemiology
It is considered less common than diffuse uterine adenomyosis .
Pathology
Focal adenomyosis most commonly occurs at the fundal endometrial-myometrial interface .
Radiographic features
Ultrasound
May be seen as a focal area of myometrical thickening. It may also present as a heterogeneous, mildly echogenic focal nodule with indistinct margins and cystic spaces . On color Doppler, tortuous vessels are typically seen coursing through the abnormality .
MRI
It is typically seen as a localized, low-signal-intensity region within the myometrium on both T2-weighted and contrast-enhanced T1-weighted sequences . This region is often continuous with the junctional zone.
Differential diagnosis
- uterine fibroid (leiomyoma)
- calcification present
- vessels displaced peripherally on color Doppler ultrasound