Presentation
Secondary infertility.
Patient Data
Enlarged uterus with a focal thickening of the endometrium-myometrium junctional zone at the fundal region (thickness = mm), seen as an ill-defined area of intermediate signal on T1and low signal on T2 in keeping with a focal adenomyosis.
Small bilateral ovarian cysts with thick enhanced wall, some of them show a high signal on T1 (hemorrhagic) in keeping with corpus luteal cysts.
There are also two ovarian cysts (13 mm on the right and 10 mm on the left) of high signal on T1, T2 shading with no enhancement on postcontrast sequences in keeping with endometriomas.
Annotated images:
green arrows indicate the ovarian endometriomas
white arrows indicate the hemorrhagic luteal cyst
Case Discussion
MRI features most consistent with a focal adenomyosis with bilateral ovarian endometriomas.
The co-existence of adenomyosis and endometriosis is reported in 20% of cases 1.
endometriosis is present in 30-50% of women presenting with infertility 2.
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