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MRI of the female pelvis: Benign disease
Dr. Seng ThipphavongAssistant Professor, University of Toronto
UHN/MSH/WCH
Organ Imaging Review October 3, 2012
No financial disclosures
Objectives
• Review pelvic MRI protocol and anatomy
• Review common benign disease entities
• Show unusual benign tumours
• Highlight acute pelvic pathology
MRI Protocol
• Ax T1• Cor, Sag, Ax T2• DCE• Buscopan or
glucagon
MRI Protocol
• Ax T1• Cor, Sag, Ax
T2• DCE• Buscopan or
glucagon
MRI Protocol
• Ax T1• Cor, Sag, Ax
T2• DCE• Buscopan or
glucagon
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Normal MRI - uterus
• Zonal anatomy
• Junctional zone
• Cervix
MRI Indications
• Uterine anomalies• Fibroids• Endometriosis, adenomyosis• Adnexal mass• Benign tumours• Acute conditions
Congenital uterine anomalies
• Agenesis• Obstructed horn• Didelphys• Complete septum• Pregnancy with uterine anomaly
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Fibroids
• Cystic degeneration• Cervical fibroid• Pedunculated ‘mass’• Pre-treatment (surgery, UFE)
planning• Growing fibroids
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Adenomyosis
• Diffuse vs focal• Lacks pseudocapsule• Ultrasound vs MRI
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Endometriosis
• Endometrioma• Kissing ovaries• Sigmoid mass• Urinary bladder mass• Abdominal wall• Invasive
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Adnexal masses
• Dermoid• Fibroma/fibrothecoma
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Acute conditions
• Post-UFE complications• Pregnancy related• Torsion
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Unusual…
• Nonovarian cystic mass• Fatty myometrial mass• Prolapsing pelvic mass
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Summary
• Review pelvic MRI protocol and anatomy
• Review common benign disease entities
• Show unusual benign tumours
• Highlight acute pelvic pathology