MRI Characteristics of the Uterine Junctional Zone: From Normal to the Diagnosis of Adenomyosis

MRI was the first imaging technique to permit the visualization of the uterine junctional zone and remains the imaging method of choice to evaluate it and its associated pathology. Adenomyosis can be diagnosed using MRI with a diagnostic accuracy of 85%. The most important MR finding in making the diagnosis is thickness of the junctional zone exceeding 12 mm. The principal limitation of MRI is the absence of a definable junctional zone on imaging, which occurs in 20% of premenopausal women.