By Martin C. Powell
Provides the functions of MRI in obstetrics and gynaecology in a close, but sensible method
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Additional resources for Magnetic Resonance Imaging in Obstetrics and Gynaecology
The accuracy rates of these modalities for parametrial evaluation were 78% for clinical evaluation, 70% for CT and 92% from MRI. Similar results have come from other centres (Sironi et al, 1990; Lien et al, 1991). The impact of these studies is lessened by the relatively small numbers of patients involved in the trials; in particular there are few patients with stage III and IV disease. Such selection bias is not surprising, as it may be difficult to persuade patients with advanced disease to undergo additional radiological examinations.
The cervical band is present throughout pregnancy, until cervical effacement has occurred. Postpartum, the low intensity band has been observed to return 24 hours after a normal delivery. There appears to be no obvious known anatomical substrate to which this band will easily correlate. Hricak et al. (1983) were the first to describe the distinctive appearance of the uterus with T2-weighted pulse sequences. Their initial proposal was that this low intensity zone had a vascular origin and represented a subendometrial venous plexus.
T = Tumour; b = bladder; c = cervix. 35 uterine cavity (Fig. 2b). However the optimum contrast and resolution required to assess an endometrial cancer are obtained when a ^ - w e i g h ted pulse sequence is employed. The tumour signal is then quite distinct from that of the surrounding myometrium. In a premenopausal uterus it may be difficult to differentiate tumour from normal endometrium unless the morphology of the uterus is altered or there is obvious myometrial invasion. The premalignant changes within the endometrium such as adenomatous hyperplasia cannot be distinguished by MRI (Fig.