[Clinical application of magnetic resonance imaging (MRI) in uterine disease].
We investigated the value of MRI in investigating uterine anatomy and disease. 1. Normal uterus: The signal intensity and endometrial thickness changed during the menstrual cycle. Endometrial thickness in the secretory phase was 12.8 +/- 3.6 mm, significantly greater than in the proliferative phase (5.4 +/- 0.7 mm, p less than 0.01). In contrast, endometrial thickness was reduced in postmenopausal women (4.1 +/- 0.9 mm) and was never over 6 mm. 2. Uterine disease: a. T2-weighted images were useful in differentiating leiomyoma and adenomyosis. Leiomyomas appeared as well-circumscribed nodules with sharp margins, while adenomyosis was seen as a low signal intensity area with an irregular border extending beneath the endometrium. b. In endometrial carcinoma, endometrial thickening with a high signal intensity was a characteristic of T2-weighted images, the maximal thickness being 16.5 +/- 6.9 mm. Moreover, endometrial carcinomas invading over 1/3 of the myometrium showed the following features: (1) The ratio of maximal endometrial thickness to uterine cross sectional diameter was over 50%. (2) The minimal myometrial thickness was under 5.0 mm. (3) The minimal to maximal myometrial thickness ratio was under 50%. Furthermore, cervical extension could be detected in all cases of endometrial carcinoma extending to the myometrium in T2-weighted images.
Department of Obstetrics and Gynecology, Iwate University School of Medicine, Morioka.
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Kasai
D000328:Adult; D000368:Aged; D003937:Diagnosis, Differential; D004715:Endometriosis / Q000175:diagnosis* / Q000473:pathology; D004717:Endometrium / Q000473:pathology*; D005260:Female; D006801:Humans; D007889:Leiomyoma / Q000175:diagnosis* / Q000473:pathology; D008279:Magnetic Resonance Imaging; D008597:Menstrual Cycle; D008875:Middle Aged; D014594:Uterine Neoplasms / Q000175:diagnosis* / Q000473:pathology; D014599:Uterus / Q000033:anatomy & histology