Imaging diagnosis of adenomyosis

Adenomyosis is a benign common gynaecological disorder whose pre-operative diagnosis has previously been elusive. The accuracy of clinical diagnosis is low as the symptoms are non-specific. The advent of high resolution imaging techniques has made an accurate non-invasive diagnosis of adenomyosis possible. Adenomyosis may also co-exist with other pathology. The histopathologic features are varied and contribute to its imaging appearances. An understanding of these features is crucial in the interpretation of the imaging findings. This review focuses on the role of the non-invasive techniques available, their accuracy and the imaging features useful in the diagnosis of adenomyosis on the various modalities. Transvaginal ultrasound (TVS) and magnetic resonance imaging (MRI) have emerged as the imaging modalities of choice in evaluating women with suspected adenomyosis. TVS is useful as the initial imaging modality with MRI reserved for cases that are indeterminate at TVS or those with co-existing pathology.