Magnetic resonance imaging of degeneration of uterine adenomyosis during pregnancy and post‐partum period

• Published in: The journal of obstetrics and gynaecology research Vol. 44; no. 6; pp. 1169 - 1173
• Main Authors: Hirashima, Hiroto, Ohkuchi, Akihide, Usui, Rie, Kijima, Shigeyoshi, Matsubara, Shigeki
• Format: Journal Article
• Language: English
• Published: Kyoto, Japan John Wiley & Sons Australia, Ltd 01.06.2018; Wiley Subscription Services, Inc
• Subjects: adenomyosis; Cesarean section; Degeneration; Fever; Gestation; Health risk assessment; Magnetic resonance imaging; NMR; Nuclear magnetic resonance; Pain; post‐partum period; Pregnancy; Uterus; magnetic resonance imaging; post-partum period; degeneration; adenomyosis; pregnancy
• ISSN: 1341-8076; 1447-0756; 1447-0756
• DOI: 10.1111/jog.13629

Degeneration of adenomyosis during pregnancy and the post‐partum period is very rare. A 42‐year‐old Japanese parous woman with four normal‐term deliveries, who presented with abdominal pain and fever at 22 weeks of gestation with transient increases of the white blood cell count and C‐reactive protein, demonstrated sustained inflammation after cesarean section at 29 weeks of gestation due to the occurrence of gestational hypertension with late deceleration. The noncontrast‐enhanced magnetic resonance imaging (MRI) at 22 weeks demonstrated a poorly demarcated hypointense area at the posterior uterine wall on T1‐ and T2‐weighted imaging. The 2nd MRI 2 weeks after the cesarean section showed hypointensity on a T1‐weighted image and hyperintensity on a T2‐weighted image, allowing confirmation of the diagnosis of degeneration of adenomyosis. Repeated MRIs were clinically useful to diagnose the degeneration of adenomyosis.