Dysmenorrhea + menorrhagia + bulky uterus, suspected adenomyosis
Recommended: Transvaginal Ultrasound + MRI Pelvis if equivocal is the preferred imaging study for dysmenorrhea + menorrhagia + bulky uterus, suspected adenomyosis. Ectopic endometrial tissue within myometrium.
Recommended study
Transvaginal Ultrasound + MRI Pelvis if equivocal
Ectopic endometrial tissue within myometrium. Often coexists with fibroids and endometriosis.
If the default doesn't apply
Pre-operative planning / equivocal US
MRI
MRI Pelvis
No contrast
Watch-outs
Mimics fibroids on imaging
Adenomyoma can mimic fibroid; lack of clear margin + linear striations favor adenomyoma.
Pearls
- MRI: junctional zone thickness > 12 mm is diagnostic.
- US: heterogeneous myometrium + cystic spaces + linear striations.
- Definitive treatment: hysterectomy; uterine-sparing options include UAE and MR-guided focused US.