Magnetic resonance (MR) imaging provides useful information for characterization of various ovarian masses as neoplastic or nonneoplastic and, when neoplastic, on a spectrum from benign to malignant. The use of MR imaging for diagnosis of ovarian masses includes consideration of morphologic characteristics and signal intensity characteristics on T1- and T2-weighted images. The morphologic characteristics of cystic masses, cystic and solid masses, and predominantly solid masses provide important information. In general, cystic masses represent benign tumors, whereas cystic and solid masses are strongly associated with malignancy. Predominantly solid masses include benign, borderline malignant, and malignant tumors. T1-weighted images provide useful information for characterization because hemorrhagic adnexal masses (eg, endometriotic cyst) and cystic teratomas can be correctly diagnosed when the mass has high signal intensity. Significant low signal intensity in solid masses on T2-weighted images is indicative of fibrothecomas and Brenner tumors because extensive fibrous tissue produces significant low signal intensity on T2-weighted images. A strategy for diagnosis of ovarian masses with MR imaging incorporates signal intensity characteristics into morphologic characteristics.

The cases of 29 patients with cervical myelopathy, who had been treated by anterior spine fusion, were reviewed. The relationship between pre- and postoperative magnetic resonance (MR) images was investigated with special reference to increased signal intensity in the spinal cord on the T2-weighted images and the relevance of this finding to clinical conditions. Preoperatively, there were areas of increased signal intensity in 12 patients whereas there were no areas of increased signal intensity in the other 17. The lesions were not clearly demonstrated on T1-weighted images. The pre- and postoperative clinical condition of the patients whose preoperative MR images showed areas of increased signal intensity in the spinal cord on T2-weighted images was worse than that of the patients who did not have areas of increased signal intensity. Of the 12 patients with regions of increased signal intensity preoperatively, five showed decreased signal intensity postoperatively compared to the preoperative levels and seven had no change. The postoperative recovery of the five patients who showed decreased signal intensity postoperatively was better than that of the seven patients who exhibited no change. The areas of increased MR signal in the spinal cord might be due to edema, cord gliosis, demyelination, or microcavities.

Magnetic resonance (MR) imaging has extended the usefulness of imaging in evaluation of pelvic disorders associated with female infertility. The causes of female infertility include ovulatory disorders (ie, pituitary adenoma and polycystic ovarian syndrome), disorders of the fallopian tubes (ie, hydrosalpinx and pelvic inflammatory disease), uterine disorders (ie, müllerian duct anomaly, adenomyosis, and leiomyoma), and pelvic endometriosis. Although laparoscopy, hysteroscopy, hysterosalpingography, and transvaginal ultrasonography are the most effective techniques for evaluation of pelvic disorders related to female infertility, MR imaging is used in a variety of clinical settings in diagnosis, treatment, and management. The applications of MR imaging include evaluation of the functioning uterus and ovaries, visualization of pituitary adenomas, differentiation of müllerian duct anomalies, and accurate noninvasive diagnosis of adenomyosis, leiomyoma, and endometriosis. In addition, MR imaging helps predict the outcome of conservative treatment for adenomyosis, leiomyoma, and endometriosis and may lead to selection of better treatment plans and management. Finally, MR imaging may serve as an adjunct to diagnostic laparoscopy and hysterosalpingography in patients with hydrosalpinx, peritubal adhesions, or pelvic adhesions related to endometriosis.

A dynamic study of magnetic resonance (MR) imaging was used to obtain successive heavily T1-weighted coronal images (spin-echo [SE] 100/15 [repetition time msec/echo time msec]) of normal pituitary glands and pituitary adenoma immediately after patients were given an intravenous bolus injection of gadopentetate dimeglumine. The images were obtained every minute for 5-8 minutes at 1.5 T. Usual T1-weighted images (SE 600/15) were also obtained before and after the dynamic study was performed. The study group consisted of 18 patients, 10 with normal pituitary glands, and eight with pituitary adenoma. Normal pituitary glands showed maximum enhancement on the first or second image following the administration of gadopentetate dimeglumine, followed by gradual signal reduction through the later images, whereas pituitary adenomas reached a peak of enhancement later and showed slower signal reduction than normal pituitaries. The difference of enhancement patterns between the normal pituitary gland and the pituitary adenoma produced prominent image contrast on the first or second image after administration of gadopentetate dimeglumine, which improved the visualization of one microadenoma and four normal pituitary glands that had been displaced by large adenomas. Dynamic MR imaging is a useful diagnostic procedure not only for detection of microadenomas, but also for visualization of pituitary glands that have been displaced by large pituitary adenomas.

No abstract