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MRI of Adenomyosis: Where Are We Today?

  • Uterine Fibroids and Endometrial Lesions (T. Tulandi, Section Editor)
  • Published:
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Abstract

Purpose of Review

The purpose of this review is to (i) summarize the current literature regarding the role of magnetic resonance imaging (MRI) in diagnosing adenomyosis, (ii) examine how to integrate MRI phenotypes with clinical symptomatology and histological findings, (iii) review recent advances including proposed MRI classifications, (iv) discuss challenges and pitfalls of diagnosing adenomyosis, and (v) outline the future role of MRI in promoting a better understanding of the pathogenesis, diagnosis, and treatment options for patients with uterine adenomyosis.

Recent Findings

Recent advances and the widespread use of MRI have provided new insights into adenomyosis and the range of imaging phenotypes encountered in this disorder.

Summary

Direct and indirect MRI features allow for accurate non-invasive diagnosis of adenomyosis. Adenomyosis is a complex and poorly understood disorder with variable MRI phenotypes that may be correlated with different pathogeneses, clinical presentations, and patient outcomes. MRI is useful for the assessment of the extent of findings, to evaluate for concomitant gynecological conditions, and potentially can help with the selection and implementation of therapeutic options. Nevertheless, important gaps in knowledge remain. This is in part due to the lack of standardized criteria for reporting resulting in heterogeneous and conflicting data in the literature. Thus, there is an urgent need for a unified MRI reporting system incorporating standardized terminology for diagnosing adenomyosis and defining the various phenotypes.

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Authors and Affiliations

  1. Department of Radiology, McGill University Health Centre, Montreal, Canada

    Michelle Zhang, Maria Tsatoumas & Caroline Reinhold

  2. Montreal Imaging Experts Inc., Montreal, Canada

    Michelle Zhang, Maria Tsatoumas & Caroline Reinhold

  3. Department of Radiology, Tenon University Hospital, Assistance Publique des Hôpitaux de Paris (AP-HP), Sorbonne Université, Paris, France

    Marc Bazot

  4. Groupe de Recherche Clinique (GRC-6), Centre Expert en Endométriose (C3E), Assistance Publique des Hôpitaux de Paris, Tenon University Hospital, Sorbonne Université, Paris, France

    Marc Bazot

  5. Department of Obstetrics and Gynecology, David Geffen School of Medicine at UCLA, Los Angeles, USA

    Malcolm G. Munro

  6. Department of Obstetrics and Gynecology, Kaiser Permanente Los Angeles Medical Center, Los Angeles, USA

    Malcolm G. Munro

  7. Codirector, Augmented Intelligence and Precision Health Laboratory of the Research Institute of McGill University Health Center, McGill University, Montreal, Canada

    Caroline Reinhold

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Dr. M.G. Munro reports grants and personal fees from AbbVie Inc. and personal fees from Myovant Inc., outside the submitted work. The other authors declare no conflict of interest.

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Zhang, M., Bazot, M., Tsatoumas, M. et al. MRI of Adenomyosis: Where Are We Today?. Curr Obstet Gynecol Rep 11, 225–237 (2022). https://doi.org/10.1007/s13669-022-00342-7

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