Conspicuity of normal and pathologic female pelvic anatomy: comparison of gadolinium-enhanced T1-weighted images and fast spin echo T2-weighted images.
OBJECTIVE
Our goal was to compare the conspicuity of normal and pathologic female pelvic anatomy between gadolinium-enhanced T1-weighted images and fast SE (FSE) T2-weighted images.


METHODS
In 48 consecutive female patients, pre- and postenhanced T1-weighted images were compared with FSE T2-weighted images acquired with a phased array coil. Normal zonal anatomy (ZA) and pathologic abnormalities in gadolinium-enhanced T1-weighted images were rated as increased, decreased, or without change in conspicuity as compared with FSE T2-weighted images.


RESULTS
The normal ZA of the uterine corpus on T1-weighted images showed a decrease in conspicuity in 93% of patients and an increase in 7% compared with FSE T2-weighted images. Conspicuity of cervical ZA on T1-weighted images was decreased in 86%, increased in 6%, and without change in 8% as compared with FSE T2-weighted images. ZA of the vagina on T1-weighted images was decreased in 94% and increased in 6% as compared with FSE T2-weighted images. On T1-weighted images, ovarian anatomy delineation was decreased in 95% and increased in 5% as compared with FSE T2-weighted images. Conspicuity of malignant pathologic abnormalities on T1-weighted images was decreased in 81%, increased in 11%, and without change in 8% as compared with FSE T2-weighted images. In patients with benign disease, conspicuity on T1-weighted images was decreased in 92%, increased in none, and without change in 8% as compared with FSE T2-weighted images. The p value for all categories was < 0.0001.


CONCLUSIONS
Conspicuity of both normal and pathologic anatomy was significantly decreased on enhanced T1-weighted images. The use of gadolinium cannot replace T2-weighted scans for delineation of anatomy and disease and should be reserved to cases in which standard imaging sequences are not sufficiently diagnostic.
Troiano
R N
RN
Department of Diagnostic Radiology, Yale University School of Medicine, New Haven, CT 06520, USA.
Lange
R C
RC
McCarthy
S
S
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003287:Contrast Media; D005260:Female; D005682:Gadolinium; D019786:Gadolinium DTPA; D005831:Genital Diseases, Female / Q000175:diagnosis; D006801:Humans; D008279:Magnetic Resonance Imaging / Q000295:instrumentation / Q000379:methods* / Q000706:statistics & numerical data; D008875:Middle Aged; D009942:Organometallic Compounds; D010388:Pelvis / Q000033:anatomy & histology* / Q000473:pathology*; D004369:Pentetic Acid / Q000031:analogs & derivatives*; D017698:Postmenopause; D017697:Premenopause; D012016:Reference Values
D003287:Contrast Media; D009942:Organometallic Compounds; D004369:Pentetic Acid; D005682:Gadolinium; D019786:Gadolinium DTPA