Abnormal uterine bleeding MRI

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Arooj Naz, M.B.B.S

MRI is not commonly performed but it is considered the modality of choice for adenomyosis. Findings for other conditions may also be seen but may not be as reliable as other imaging studies. MRI can assist in furthering diagnosis metastasis.

MRI Findings

Underlying Cause	MRI	Findings
Endometrial Polyps[1]		Hypointense intracavitary masses Surrounded by fluid and endometrium
Adenomyosis[2]		Diagnosis of choice; sensitivity of 78-88% and specificity of 67-93% Thickening of the junctional zone ≥12 mm (normal is up to 5 mm) Appears as an ill-defined region of thickening
Leiomyoma[3]		Only used for complex cases May accurately determine size and location Appear hypervascular Helpful when surgery is considered or when trying to differentiate from fibroids
Malignancy[4]		MRI may be helpful in improving accuracy for determining metastasis Normal tissue enhances more than malignant tissue
PCOS[5]		Not a routine examination for PCOS Ffollicles will be seen on MRI
Endometrial Causes [6]		Endometrioma appears hyperintense; the presence of hemorrhage results in a hypointense image

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