MRI OF THE PELVIS:
DATE OF STUDY: MM/DD/YYYY
Multiplanar images were obtained without and with contrast. The uterus is anteverted. There are no uterine masses. The endometrial lining appears unremarkable. The cervix and vagina appear grossly unremarkable. The ovaries are difficult to localize with certainty. There is no presacral mass. There is a normal appearance to the bladder. No abnormal masses are readily appreciated in the pelvis. Marrow signal within the bony structures is unremarkable. There are no bony masses.
IMPRESSION: Unremarkable MRI of the pelvis. The uterus, endometrial lining, cervix, vagina all appear grossly unremarkable. There are no masses. The ovaries are difficult to identify with certainty. If clinically warranted, a pelvic ultrasound may also be of value to evaluate the ovaries.
DATE OF STUDY: MM/DD/YYYY
Multiplanar images were obtained without and with contrast. The uterus is anteverted. There are no uterine masses. The endometrial lining appears unremarkable. The cervix and vagina appear grossly unremarkable. The ovaries are difficult to localize with certainty. There is no presacral mass. There is a normal appearance to the bladder. No abnormal masses are readily appreciated in the pelvis. Marrow signal within the bony structures is unremarkable. There are no bony masses.
IMPRESSION: Unremarkable MRI of the pelvis. The uterus, endometrial lining, cervix, vagina all appear grossly unremarkable. There are no masses. The ovaries are difficult to identify with certainty. If clinically warranted, a pelvic ultrasound may also be of value to evaluate the ovaries.
MRI OF THE PELVIS:
DATE OF STUDY: MM/DD/YYYY
REFERRING PHYSICIAN: John Doe, MD
INDICATION FOR STUDY: Stage III adenocarcinoma of the endometrium.
TECHNIQUE AND FINDINGS: Once again, we do not see abnormal signal within the bony structures of the pelvis to indicate metastasis.
There is mottled and irregular uptake of the uterus and the vaginal wall, extending down including the cervix. Of course, all of this can be tumor and edematous change. This includes the cervix.
We do see some high signal involving a small area of tissue to the right lateral and anterior aspect of the uterus and following the expected location of the broad ligament. This could represent some localized tumor spread.
There is also some mild irregularity to the left side of the uterus. This is not substantial, presents as small stranding and some contour, mild protuberance from the uterus itself.
What is suggested on this examination is an abnormal uterus, which is already known clinically, abnormal enhancement of the vagina, which is more mottled than is commonly seen, and more gadolinium uptake in the cervix than is sometimes seen. This could be due to examination and trauma and contusion or due to tumor spread.
Although there are no large areas of lymphadenopathy along the external iliac or internal iliac causeways suggested on this examination to indicate significant lymphadenopathy, there does appear to be a small amount of irregularity around the uterus itself and some areas, which do enhance in the area of what is presumed to be the more central component of the broad ligament.
IMPRESSION:
1. Abnormal uptake of gadolinium in the uterus, as one would expect from the clinical history and some mottling throughout the vaginal wall and uptake in the cervix directly behind the vaginal wall, in front of the bowel. Although there is not large lymphadenopathy noted in the pelvic examination, there is some irregularity to the uterine wall and some mild high signal related to that irregular uterine wall and in one instance beginning to follow the right broad ligament’s expected course. These areas could indicate some local invasion.
2. The pelvic bones do not show abnormal enhancement to indicate metastasis. Subcutaneous fat and muscle planes also appear intact.