title: MR imaging of diffuse adenomyosis changes after GnRH analog therapy.
abstract: 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.
authors.affiliation: Department of Radiology, Georgetown University Medical Center, Washington, DC, USA. izmcha@hkg.odn.ne.jp
authors.forename: Izumi
authors.initials: I
authors.lastname: Imaoka
authors.forename: Susan M
authors.initials: SM
authors.lastname: Ascher
authors.forename: Kazuro
authors.initials: K
authors.lastname: Sugimura
authors.forename: Kentaro
authors.initials: K
authors.lastname: Takahashi
authors.forename: Hong
authors.initials: H
authors.lastname: Li
authors.forename: Felicia
authors.initials: F
authors.lastname: Cuomo
authors.forename: James
authors.initials: J
authors.lastname: Simon
authors.forename: Lori L
authors.initials: LL
authors.lastname: Arnold
mesh_terms: 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
chemical_list: D007987:Gonadotropin-Releasing Hormone