Vaginal masses: magnetic resonance imaging features with pathologic correlation

Abstract

The detection of vaginal lesions has increased with the expanding use of cross-sectional imaging. Magnetic resonance imaging (MRI) - with its high-contrast resolution and multiplanar capabilities - is often useful for characterizing vaginal masses. Vaginal masses can be classified as congenital, inflammatory, cystic (benign), and neoplastic (benign or malignant) in etiology. Recognition of the typical MR imaging features of such lesions is important because it often determines the treatment approach and may obviate surgery. Finally, vaginal MR imaging can be used to evaluate post-treatment changes related to previous surgery and radiation therapy. In this article, we will review pertinent vaginal anatomy, vaginal and pelvic MRI technique, and the MRI features of a variety of vaginal lesions with pathological correlation.

Vaginal leiomyoma presenting as a lateral vaginal wall mass

“…A vaginal leiomyoma typically appears as a round homogenous lesion with similar signal to that of the myometrium, with multiple calcifications. 16 The absence of calcifications is a consistent finding in leiomyosarcomas. 17 The presence of intra-lesional haemorrhage makes the diagnosis of a sarcoma more likely.…”

A Rare Case of Anterior Vaginal Wall Leiomyoma

“…They usually occur as single, well-circumscribed mass arising from the midline anterior wall [1,3] and less commonly, from the posterior and lateral walls [4]. They may be asymptomatic, but depending on the site of occurrence, they can give rise to varying symptoms including lower abdominal pain, low back pain, vaginal bleeding, dyspareunia, frequency of micturition, dysuria, or other features of urinary obstruction.…”

Imaging of female pelvic malignancies regarding MRI, CT, and PET/CT

“…After contrast application, the tumor also presents an inhomogeneous pattern. Some tumors have a pseudocapsula which is hypointense in both T1-weighted and T2-weighted sequences [12,23]. Regarding leiomyosarcoma of the vagina, which is often already palpable due to fast tumor growth and large size, MR images may reveal an extensive tumor mass in the pelvis.…”