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MRI of the pelvis is a powerful tool to image the female pelvis useful in both benign and malignant disease.

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Benign Disease

MRI can be useful in specific situations including:

  • Differentiate subserosal fibroid from adnexal mass identified at ultrasound
  • Primary diagnosis of adenomyosis as alternative to fibroids in pre-menopausal vaginal bleeding
  • Congenital abnormalities of uterus and vagina. For example, distinguishing septate from bicornuate uterus
  • Other

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Coronal T2 weighted MR image in patient with uterus didelphys demonstrates splayed, duplicated uterine horns (asterisks).

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T2 weighted image demonstrates two cervical channels in same patient with uterus didelphys (asterisks).

Malignant Disease

MRI is becoming increasingly accepted as a means to stage primary cancers of the uterus, cervix and ovaries. In these cases, MRI can often obviate older staging systems, eliminating less sensitive tests, and identifying patients ahead of time who would benefit from pre-operative chemotherapy or radiation before staging surgery.

    Indications include:
  • Staging of depth of penetration of primary uterine adenocarcinoma
  • Extent of tumor and parametrial status of primary cervical carcinoma
  • Assessment of peritoneal and serosal metatstatic disease in ovarian carcinoma (primary presentation or post-treatment)

Uterine Cancer

Identifying the depth of myometrial penetration of tumor may modify staging pre-operatively and determine whether pre-operative chemo or radiation therapy would be beneficial.

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Post contrast sagittal MR image of uterus demonstrates mildly enhancing tumor (arrowheads) with only superficial depth of penetration of myometrium. Preoperative chemoradiation not necessary.

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Sagittal T2 weighted image confirms the post contrast image assessment of only superficial penetration of the low signal tumor (arrowheads). Preoperative chemoradiation not needed.

Cervical Cancer

MRI can improve confidence in staging cervical tumors and determine appropriate timing of surgery and other adjunctive treatments.

Studies have shown that MRI modifies the initial FIGO staging of tumors.

Case 1:

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Axial T2 weighted image in patient with cervical cancer extending into right parametrium (arrowheads).

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Axial T1 weighted image demonstrates spread of cervical tumor into both parametrium (arrowheads) and mesorectal fascia.

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Coronal T1 weighted image demonstrates spread of cervical tumor into right parametrial fat (arrowheads).

Case 2:

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Sagittal T2 weighted image demonstrates cervical tumor confined within the cervix (arrowheads) Stage Ia.

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Sagittal post contrast fat saturated T1 weighted image demonstrates tumor has minimal penetration into cervical stroma (arrowhead).

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Axial T2 weighted image demonstrates cervical tumor within the cervical canal (arrowheads), without penetration of cervical stroma - Stage Ia.

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Coronal T2 weighted image demonstrates splaying of the endocervical canal by the tumor (arrowheads).

Other Services


 
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Core Biopsy
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Screening Mammography
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Breast Ultrasound
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Breast MRI
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Ductography
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Uterine Artery Embolization
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Multi-Detector Row CT
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Peripheral MRA of the Extremities
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Cardiac MRI
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