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MRI of the pelvis is a powerful tool to image the female pelvis useful in both benign and malignant disease.
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
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.
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:
Case 2:
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