Magnetic resonance (MR) imaging characteristics of adenomyosis were studied in eight women (aged 37-49 years) who underwent hysterectomy, and detailed radiologic/pathologic correlation was conducted in all cases. Adenomyosis produced diffuse and smooth uterine enlargement. The extent of the lesion was clearly identified on images obtained with long repetition time and long echo time; a diffuse, low-intensity area accompanied by tiny high-intensity spots was seen subjacent to the endometrium. The area appeared as a localized or diffuse thickening of the junctional zone because it was often isointense with this zone. Pathologic examination confirmed that the extent of adenomyosis correlated well with the low-intensity region on MR images and that both hemorrhagic areas and nonbleeding endometrial tissue corresponded to the high-intensity spots. The lesion consisted of distorted and compacted smooth muscle cells, but microscopic studies failed to explain the definitive difference in intensity between areas of adenomyosis and myometrium.
Magnetic resonance (MR) imaging was performed in eight healthy volunteers and 30 patients with histologically and endocrinologically proved thyroid diseases. The use of a surface coil greatly improved spatial resolution, and normal anatomic structures were well demonstrated. In thyroid tumors, the margin, pseudocapsule, and lymph nodes were easily detected. Smooth margins, lobulated margins, and pseudocapsules were found in both adenoma and papillary carcinoma, whereas unclear margins were found only in papillary carcinoma. An unclear margin between the tumor and adjacent normal thyroid tissue seemed to reflect an ill-defined tumor border on gross pathologic examination. Metastatic lymph nodes as small as 3 mm were seen. Identification of small vessels enabled detection of dilated vessels in thyroid parenchyma in patients with Graves disease. Hemorrhage (hemorrhagic degeneration) was often found in adenoma, papillary carcinoma, and adenomatous goiter, resulting in variable signal intensity.
Vaginal agenesis was studied by magnetic resonance (MR) imaging lin a 15-year-old girl, a 19-year-old woman, and a 21-year-old woman. In each case MR studies demonstrated the presence or absence of a normal cervix and functioning endometrium. This information was useful in planning surgical management. MR imaging assisted in the classification of the abnormality by noninvasively demonstrating the details of pelvic anatomy-and the uterine morphologic characteristics.
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