Findings:
Retroverted enlarged uterus with diffuse thickening of the junctional zone endometrium-myometrium (up to 20 mm) of intermediate signal on T1, and low signal on T2 in keeping with diffuse adenomyosis. A small cystic lesion is seen attached to the superior uterine wall on the left.
Right ovary is fixed to the upper uterus. Left ovary position anterior/inferior to the uterus. No endometrioma.
Fallopian tubes show no haematoma or hydrosalpinges.
A large stromal/fibrotic soft tissue can be seen surrounding the cervix, obliterating the pouch of Douglas, traversing the retrocervical space, and invading the rectum (at 7 cm from anal opening), measuring approximately 7 x 4 cm on the axial images.
Thickened uterosacral ligaments and torus uterinus. Torus uterinus is fixed to the rectum.
There is no lymphadenopathy, no ascites.
No bony abnormality is seen.
Impression:
MRI features most consistent with diffuse uterine adenomyosis with deep endometriosis involving the rectovaginal septum, obliterating the pouch of Douglas and infiltrating the rectum at 7 cm from anal opening.