Schlattau, Alexander; Cunha, Teresa Margarida; Forstner, Rosemarie
Incidental adnexal masses are commonly identified
in radiologists’ daily practice. Most of
them are benign ovarian lesions of no concern.
However, sometimes defining the origin of a
pelvic mass may be challenging, especially on
ultrasound alone. Moreover, ultrasound not
always allows the distinction between a benign
and a malignant adnexal tumor.
Most of sonographically indeterminate
adnexal masses turn out to be common benign
entities that can be readily diagnosed by magnetic
resonance imaging. The clinical impact
of predicting the likelihood of malignancy is
crucial for proper patient management.
The first part of this chapter will cover the
technical magnetic resonance imaging aspects
of ovarian lesions characterization as well as the
imaging features that allow the radiologist to
Para além da apresentação de dados bio e bibliográficos do Doutor Bernardino António Gomes, com esta publicação pretende-se traçar um quadro geral da saúde pública e da medicina coeva de uma das figuras médicas mais relevantes dos séculos XVIII e XIX, a nível nacional e europeu. Ao evidenciar o carácter inovador e visionário deste homem de ciência, destaca-se, ainda, o seu papel e obra como médico da Armada, médico de saúde pública e dermatologista, enquanto membro das mais importantes instituições de produção do conhecimento científico e da governação em saúde, tais como a Academia Real das Ciências, a Junta de...
Dias, João Lopes; Cunha, Teresa Margarida
Magnetic resonance imaging (MRI) and computed
tomography (CT) are routinely used in
female pelvis imaging. MRI is primarily useful
for locoregional characterization of benign
and malignant diseases. CT is less accurate in
locoregional evaluation, but remains useful in
the follow-up of treated gynecological malignancies,
as well as in the setting of emergency
and in the guidance of biopsies. Although
transabdominal and transvaginal ultrasonography
(US) is not under the scope of this chapter,
it remains the first-line imaging method
for most gynecological conditions.
Bazot, M.; Bharwani, N.; Huchon, C.; Kinkel, K.; Cunha, T. M.; Guerra, A.; Manganaro, L.; Buñesch, L.; Kido, A.; Togashi, K.; Thomassin-Naggara, I.; Rockall, A. G.
Endometriosis is a common gynaecological condition of unknown
aetiology that primarily affects women of reproductive
age. The accepted first-line imaging modality is pelvic ultrasound.
However, magnetic resonance imaging (MRI) is increasingly
performed as an additional investigation in complex cases and for surgical planning. There is currently
no international consensus regarding patient preparation, MRI
protocols or reporting criteria. Our aim was to develop clinical
guidelines for MRI evaluation of pelvic endometriosis based
on literature evidence and consensus expert opinion. This
work was performed by a group of radiologists from the European Society of Urogenital Radiology (ESUR), experts in
gynaecological imaging and a gynaecologist expert in methodology.
The group discussed indications for MRI,...
Pereira, Pedro; Abreu, Elisa Melo; Cunha, Teresa Margarida; Rolim, Inês
A 45-year-old woman with a history of total hysterectomy
with adnexal preservation for uterine leiomyomas
presented to our hospital with a right gluteal palpable
mass, which she first noticed 6 months before and had
progressively enlarged since then.
Radiological studies revealed a 14 cm lesion with
translevator growth that displaced rather than invaded
adjacent structures, with a peculiar whorled pattern on
T2-weighted MRI, which enhanced following gadolinium
administration. CT-guided biopsy was performed, and in
conjunction with imaging features the diagnosis of an
aggressive angiomyxoma was assumed and confirmed
following surgical excision.
Forstner, Rosemarie; Thomassin-Naggara, Isabelle; Cunha, Teresa Margarida; Kinkel, Karen; Masselli, Gabriele; Huch, Rahel Kubik; Spencer, John; Rockall, Andrea
An update of the 2010 published ESUR recommendations of
MRI of the sonographically indeterminate adnexal mass integrating
functional techniques is provided. An algorithmic approach
using sagittal T2 and a set of transaxial T1 and T2WI
allows categorization of adnexal masses in one of the following
three types according to its predominant signal characteristics.
T1 'bright' masses due to fat or blood content can be
simply and effectively determined using a combination of
T1W, T2W and FST1W imaging. When there is concern for a solid component within such a mass, it requires additional
assessment as for a complex cystic or cystic-solid mass. For
low T2 solid adnexal masses, DWI is now...