CT features of adenomyosis

ObjectivesTo determine the computed tomography (CT) features of adenomyosis in patients with known adenomyosis as established with magnetic resonance (MR) imaging.MethodsA computerized search identified 16 women with pelvic MR diagnosis of adenomyosis who also had enhanced pelvic CT. Original CT reports were reviewed for potential prospective diagnosis of adenomyosis. CT images were reviewed for enhancement phase, inner and outer myometrium attenuation, uterine enlargement (width>6 cm), inner myometrial thickening (≥12 mm), and myometrial cysts.ResultsAdenomyosis was detectable on CT in 8 of 16 patients. For these 8 patients, inner and outer myometrium distinction was excellent in 7 (88%) and limited in 1 (12%), and mean inner myometrial thickness was 25 mm (range 14–47 mm). CT enhancement phase was parenchymal in 7 (88%), uterus was enlarged in 8 (100%), and 7 (88%) had myometrial cysts. Adenomyosis was focal in 5 (63%), diffuse in 2 (25%), and both in 1 (12%). None of the original CT reports included adenomyosis as a diagnosis.ConclusionsCT can suggest a diagnosis of adenomyosis based on uterine enlargement, thickened inner myometrium, and/or myometrial cysts.