Uterine neoplasms: MR imaging.

Abstract

Magnetic resonance (MR) studies were performed on 20 healthy volunteers and 41 patients with proved cervical and uterine neoplasms. MR imaging demonstrated normal uterine landmarks in all patients. On T2-weighted images, the normal uterine wall could be differentiated into three distinct layers: a central high-intensity zone, a junctional low-intensity band, and a peripheral medium-intensity area. While most of the normal cervices had only two distinct zones (central high-intensity zone and peripheral low-intensity zone), a small percentage had three layers of signal intensity, similar to the uterine body. Primary cervical and uterine neoplasms could be identified on MR images. In 18 of 22 patients with proved carcinoma, a mass with a signal intensity higher than that of normal cervical lips was seen on T2-weighted images. Endometrial carcinoma was most often identified as expansion of the central high-intensity area; discrete tumor nodules were visible in nine of 15 patients. Mixed müllerian sarcoma appeared as a large pelvic mass with complete obliteration of normal uterine landmarks. MR imaging delineates primary cervical and endometrial carcinoma better than computed tomography does.

MR imaging of the cervix: off-axis scan to improve visualization of zonal anatomy

“…The cervix typically has a high-signal central zone from the endocervical canal with surrounding low signal intensity from the fibrous stroma of the uterus. An additional layer of intermediate signal intensity more peripherally also has been seen in some patients [4] (Fig. 1C).…”

“…The delineation of various anatomic layers within the uterus and cervix has been noted on 12-weighted, SE sequences [4,7,8]. In the uterine body, three layers of different signal intensity can be identified (Fig.…”

“…Carcinoma of the cervix is detected on 12-weighted images as a focus of high signal intensity that can be distinguished from the otherwise normal low signal of the cervical stroma [4,6,7]. MR imaging often allows demonstration of the primary tumor location, the depth of cervical stromal invasion, and the extension of tumor into the uterine body and/or parametrium [7].…”

Carcinosarcoma of the Uterus: Magnetic Resonance Imaging

“…In such patients, MRI may be useful for detection of intrauterine lesions. MRI is becoming an accepted and useful modality for the evalua tion of endometrial carcinoma as it provides direct tumor visualization and offers more accurate clinical staging compared with other imaging modalities, and contrastenhanced MR images with Gd-DTPA improve both tu mor detection and assessment of the depth of myometrial invasion [2][3][4], However, there is no report of contrastenhanced MR images with Gd-DTPA for detection of car cinosarcoma [5,6].…”

“…The clinical usefulness of magnetic resonance imaging (MRI) in the evaluation of endometrial carcinoma has been reported [2][3][4]. However, there are few reports of MRI for the diag nosis of carcinosarcoma, and the specific MRI findings of this tumor have not been reported [5,6], In the present report, we describe the MRI findings in a patient with car cinosarcoma.…”