Findings:
Bulky anteverted anteflexed uterus with LSCS scar in the lower anterior uterine wall showing foci of old hemorrhage.
There is significant thickening of endo-myometrial junctional zone, predominantly in the anterior uterine wall and measures approx. 24 mm in maximum thickness.
Obliteration of the retro-cervical recess with hypointense spiculated, enhancing mass-like focal thickening and stranding which is inseparable from the anterior mesorectal fascia of the rectum. Spiculation within the surrounding fat corresponds to the fibrotic reaction. No obvious involvement of the rectum.
Small fibrotic bands/adhesions extending into bilateral adnexal and anterior perirectal regions.
The uterosacral ligaments are thickened with nodular margins.
Both ovaries are enlarged and contain an abnormally large number of follicles (>10-12 each). All follicles show a more-or-less similar size with no dominant follicles detected (size <10 mm). No endometrioma.
Tetraction of the ovaries and fallopian tubes towards the torus uterinus.
The urinary bladder is unremarkable.
No visible suspicious pelvic lymph nodes, unremarkable neurovascular structure. No abdominal wall mass lesion.
No bony abnormality is seen.
Impression:
Findings suggests diffuse adenomyosis and deep pelvic endometriosis with involvement of the posterior and middle compartments.