Role of diffusion weighted imaging (DWI)‎ of MRI study in differentiation between adenomyosis and fibroids of the Uterus in al-Hilla Teaching Hospital

Abstract EN

The uterine fibroid is most common solid uterine tumour , it is single or multiple benign neoplasm and present in 20-40% of women in productive age.

There are several factors that are attributed to underlie the incidence and development of these common tumors, but this further corroborates their relatively unknown etiology.

The most likely presentation of fibroids is by their effect on pelvic pressure symptoms or the woman’s menstrual cycle .Adenomyosis of the uterus is benign uterine pathology.

It is thought by many to be on the spectrum of endometriosis, with ectopic endometrial glandular tissue in the myometrium.

Adenomyosis may present with dysmenorrhea and menorrhagia.

Ultrasound and MRI are imaging modalities that may show characteristic findings.

Diffusion weighted image in MRI has been applied to evaluate the intracranial lesion ,but technical advancement make it possible to use in extra cranial sites.

The aim of this study was to assess the differences, if any, in the apparent diffusion coefficient (ADC) values of adenomyosis and fibroids.

Methods and Material Total patient of sample study 56 ,Patients (n= 25) diagnosed by ultrasound as uterine fibroids and (n=31) as adenomyosis, who underwent pelvic MR imaging with DWI, were included in this cross section study.

DWI was achieved with using a 1.5 T scanner , different b factors of ( 0, 400, and 600 s/mm) and ADC region of interest(ROI) size were located over an area of Adenomyosis, a fibroid and unaffected normal myometrium all results are correlate with histopathological result which was considered as gold standard diagnostic methods.

Results using Student’s t test to compare the ADC values of adenomyosis and fibroids.

The standard deviation and the mean of the ADC values were as follows: adenomyosis 0.75 ± 0.30, fibroid 0.63 ± 0.29 and myometrium 1.39 ± 0.36.

Statically, there was significant difference between the ADC values of normal myometrium and adenomyosis (p < 0.0001), normal myometrium and fibroids (p < 0.0001), and fibroids and adenomyosis (p < 0.001).

Conclusion The present study display that ADC values have the possible to quantitatively and significantly differentiate between Adenomyosis and fibroids.