MR imaging of diffuse adenomyosis changes after GnRH analog therapy.
OBJECTIVE
To evaluate uterine changes on MRI before and after GnRH analog (GnRHa) treatment in diffuse adenomyosis.


METHODS
Thirty-one patients with MRI features suggestive of diffuse adenomyosis received GnRHa for 6 months. Diffuse adenomyosis was sub-classified as: symmetric (symmetric/ entire widening of the junctional zone [JZ]) and asymmetric (asymmetric/ partial widening of JZ). Pre- and post-high signal intensity (SI) foci and JZ width, and post-demarcated change (interface of adenomyosis with the myometrium became more discrete with a concomitant decrease in JZ width) were analyzed.


RESULTS
Before therapy, 15 of 18 asymmetric contained high SI foci compared to none of symmetric. After therapy, JZ width decreased (P < 0.0001). Eight asymmetric and none of symmetric showed demarcated change with resolved high SI foci.


CONCLUSIONS
Our results suggest the use of GnRHa is associated with a decrease of JZ width in adenomyosis. Asymmetric adenomyosis with high SI foci appears to be the most sensitive to hormonal therapy.
Imaoka
Izumi
I
Department of Radiology, Georgetown University Medical Center, Washington, DC, USA. izmcha@hkg.odn.ne.jp
Ascher
Susan M
SM
Sugimura
Kazuro
K
Takahashi
Kentaro
K
Li
Hong
H
Cuomo
Felicia
F
Simon
James
J
Arnold
Lori L
LL
D000328:Adult; D004715:Endometriosis / Q000188:drug therapy* / Q000473:pathology; D005260:Female; D007987:Gonadotropin-Releasing Hormone / Q000627:therapeutic use*; D006801:Humans; D008279:Magnetic Resonance Imaging; D008875:Middle Aged; D011446:Prospective Studies; D016896:Treatment Outcome; D014599:Uterus / Q000187:drug effects* / Q000473:pathology
D007987:Gonadotropin-Releasing Hormone