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...