Uterine junctional zone: correlation between histologic findings and MR imaging.

Abstract

Uterine zonal anatomy as visualized on T2-weighted (repetition time, 2,500 msec; echo time, 80 msec) magnetic resonance (MR) images consists of a high-intensity central (endometrial) zone, a subjacent low-intensity junctional zone of myometrium, a moderately intense zone of myometrium, and a thin, low-intensity subserosal zone of myometrium. To better define the histologic correlates of these diagnostically significant zones, T2-weighted MR images of 17 in vivo and 13 extirpated human uteri were compared with histologic sections of 17 uteri stained with hematoxylin-eosin, Mallory trichrome, and immunofluorescence staining for actin. Morphometric and electron microscopic observations of uterine surgical specimens were also made. The observations indicate that both the junctional zone and the subserosal zone consist of compact smooth muscle fibers with little extracellular matrix compared with the myometrium proper. Also, the junctional zone is divided into a compact region and a transitional region. The compact region correlates well with the hypointense MR appearance of the junctional zone.

Metformin inhibits growth of eutopic stromal cells from adenomyotic endometrium via AMPK activation and subsequent inhibition of AKT phosphorylation: a possible role in the treatment of adenomyosis

“…Adenomyosis is usually diagnosed by histological evaluation of a hysterectomy specimen showing invasion of endometrial tissue into the myometrium (Brown et al 1991). Ultrasound or magnetic resonance imaging (MRI) may aid in the nonsurgical diagnosis of adenomyosis, with MRI having 78-88% sensitivity and 67-93% specificity (Ascher et al 1994, Reinhold et al 1996, Atri et al 2000, Dueholm et al 2001, Bazot et al 2001.…”

“…Patients typically present with menorrhagia, dysmenorrhea, metrorrhagia, and dyspareunia, which may be a cause of reduced fertility (Devlieger et al 2003, Takeuchi & Matsuzaki 2011. Surgical hysterectomy remains the only definitive treatment (Brown et al 1991, Devlieger et al 2003. Surgery is usually physiologically and psychologically traumatic for patients of reproductive age, highlighting the need to develop novel and effective treatments.…”

Diffusion-weighted and diffusion-tensor imaging of normal and diseased uterus

“…DWI and DTI of uterus T1weighted sequences [9] . The junctional zone is the inner band of the myometrium and shows a low signal intensity in comparison to myometrial zone on T2 weighted sequences, probably because of multifactorial reasons [10] . Existence of compact smooth muscles, low water content of the cells, and increased large nuclei are the contributing factors [10,11] .…”

“…The junctional zone is the inner band of the myometrium and shows a low signal intensity in comparison to myometrial zone on T2 weighted sequences, probably because of multifactorial reasons [10] . Existence of compact smooth muscles, low water content of the cells, and increased large nuclei are the contributing factors [10,11] . The outer band of myometrial zone shows high signal intensity on T2 weighted sequences than the junctional zone, with high cellular water content and low cell density [9] .…”

Adenomyosis and endometriosis have a common origin

“…menarche, postmenopausal, phase of menstrual cycle, and use of oral contraceptives). This variability has made it difficult to define the "normal" uterine zonal anatomy on MR imaging 32,33 .…”