Widyaningrum Saraswati, Mardiyana Lies
Department of Radiology, Dr. Soetomo General Academic Hospital, Surabaya.
Department of Radiology, Faculty of Medicine - UNIVERSITAS AIRLANGGA, Surabaya.
Radiol Case Rep. 2024 Jul 20;19(10):4201-4207. doi: 10.1016/j.radcr.2024.06.095. eCollection 2024 Oct.
Myometrial hypertrophy and hyperplasia, which usually on magnetic resonance imaging (MRI) typically reveal an enlarged uterus with ill-defined areas of low signal intensity and a diminished junctional zone, along with small foci of hyperintensity due to ectopic endometrium, are found in uterine adenomyosis. Those are caused by the presence of ectopic endometrial glands and stroma within the uterine myometrium. However, our case reports highlight the importance of recognizing atypical presentations, such as extensive mass-like hyperintense signals resembling a "Fish in a Net" and Swiss cheese pattern on T2-weighted imaging. Recognizing this pattern could aid in preventing misdiagnosis and guiding appropriate management strategies. Furthermore, there is a possibility that the same diagnosis (adenomyosis) could present a different β-human choriogonadotropin hormone (β-HCG) serum level.
子宫腺肌病中可发现子宫肌层肥大和增生，在磁共振成像（MRI）上通常表现为子宫增大，低信号强度区域边界不清，结合带变窄，同时存在因异位内膜导致的小片状高信号灶。这些是由子宫肌层内异位的子宫内膜腺体和间质所致。然而，我们的病例报告强调了认识非典型表现的重要性，例如在T2加权成像上出现类似“网中鱼”和瑞士奶酪样的广泛肿块样高信号。认识到这种表现有助于防止误诊并指导适当的管理策略。此外，同一诊断（子宫腺肌病）可能呈现不同的β-人绒毛膜促性腺激素（β-HCG）血清水平。
