1) Benign uterine diseases like adenomyosis and leiomyomas are common gynecologic conditions that affect women of all ages.
2) Ultrasound is the first-line imaging technique while MRI is the most accurate tool for diagnosing lesions and guiding patient management.
3) MRI can identify typical and atypical findings of adenomyosis and leiomyomas and help evaluate treatment options such as myomectomy, uterine artery embolization, and hysterectomy.
Presentation1.pptx, radilogical imaging of ovarian lesions.Abdellah Nazeer
Pelvic inflammatory disease (PID) is an infection of the female upper genital tract that is a common complication of sexually transmitted diseases. It can cause long-term issues like chronic pelvic pain, infertility, and ectopic pregnancy due to scarring and adhesions. PID includes conditions like endometritis, salpingitis, and tubo-ovarian abscess. Prompt diagnosis and treatment are important to prevent life-threatening complications due to the varied presentation and sometimes difficultly in detection of PID. Radiological imaging can help identify signs of PID and related conditions like tubo-ovarian abscesses.
Presentation1.pptx, radiological imaging of uterine lesions.Abdellah Nazeer
This document discusses radiological imaging techniques for evaluating various uterine lesions. It provides details on congenital uterine anomalies, pelvic inflammatory disease, endometriosis, adenomyosis, leiomyomas (fibroids), and endometrial polyps. Transvaginal ultrasound, CT, MRI, and hysterosalpingography are described as methods for diagnosing these conditions. Symptoms can include abnormal bleeding, pelvic pain, and infertility. Early diagnosis is important but can be challenging without invasive methods.
Pelvic inflammatory disease (PID) is an infection of the female upper genital tract that can cause long-term complications like chronic pelvic pain, infertility, and ectopic pregnancy if not promptly diagnosed and treated. It encompasses several conditions that may present asymptomatically or with mild to severe symptoms, making diagnosis difficult. Radiological imaging can help identify complications of PID like tubo-ovarian abscesses. The document then reviews various ovarian pathologies that may be identified on imaging such as cysts, tumors, and cancers of epithelial, stromal, and germ cell origin.
The document discusses adenomyosis, a benign condition where endometrial tissue grows within the uterine wall. It defines adenomyosis and describes associated symptoms like pelvic pain and abnormal bleeding. Diagnosis can only be confirmed by pathology after hysterectomy, though other imaging methods like ultrasound and MRI can provide clues. TVUS shows heterogeneous myometrial texture while MRI may detect increased thickness or consistency changes in the myometrium.
Presentation1, radiological imaging of endometrial carcinoma.Abdellah Nazeer
MRI is a valuable tool for assessing endometrial cancer by depicting tumor size, extension into the myometrium or parametrium, cervical invasion, and lymphadenopathy. It plays an important role in pre-operative planning by identifying high-risk features that may require lymph node dissection or adjuvant therapy. While endometrial cancer is surgically staged, MRI can accurately assess key features to guide treatment. It can also differentiate endometrial cancer from benign conditions like hyperplasia, adenomyosis, or fibroids.
This document provides information on endometrial carcinoma, cervical cancer, and uterine sarcomas as assessed by MRI. It begins with an overview of endometrial carcinoma histology and prognosis factors. It then details the MRI protocol for evaluating these cancers, including sequences used. The document describes the typical MRI appearances of these cancers and their stages according to FIGO classification. It concludes with sections on the MRI features of various uterine sarcomas, including leiomyosarcoma, endometrial stromal sarcoma, undifferentiated endometrial sarcoma, and adenosarcoma.
Presentation1.pptx, radiological imaging of female infertility.Abdellah Nazeer
This document discusses radiological imaging for evaluating female infertility. It begins by defining infertility and describing its prevalence. Imaging plays a key role in the diagnostic evaluation of infertility in women. Hysterosalpingography is often the initial study to evaluate fallopian tube patency. Additional imaging with ultrasound, MRI, or hysterography may be needed to further characterize any abnormalities. The document then discusses various causes of infertility related to the uterus, ovaries, fallopian tubes, and hormones. It describes imaging findings for specific conditions like endometriosis, polycystic ovaries, and Müllerian duct anomalies. The appropriate use of imaging modalities is important for directing patient care and management of infertility.
The document discusses the ultrasound and MRI appearance of the normal endometrium and various endometrial pathologies including polyps, hyperplasia, and carcinoma. It describes how the endometrium changes in appearance throughout the menstrual cycle in pre- and postmenopausal women. Endometrial polyps appear as focal masses or thickening on ultrasound and low signal masses on MRI. Hyperplasia is suggested by endometrial thickness over 10mm. Endometrial carcinoma demonstrates irregular thickening or an intracaity mass and can invade the myometrium or cervix in advanced stages. The 2009 FIGO staging system for endometrial cancer is outlined. MRI is useful for staging by evaluating myometrial
Presentation1.pptx, radilogical imaging of ovarian lesions.Abdellah Nazeer
Pelvic inflammatory disease (PID) is an infection of the female upper genital tract that is a common complication of sexually transmitted diseases. It can cause long-term issues like chronic pelvic pain, infertility, and ectopic pregnancy due to scarring and adhesions. PID includes conditions like endometritis, salpingitis, and tubo-ovarian abscess. Prompt diagnosis and treatment are important to prevent life-threatening complications due to the varied presentation and sometimes difficultly in detection of PID. Radiological imaging can help identify signs of PID and related conditions like tubo-ovarian abscesses.
Presentation1.pptx, radiological imaging of uterine lesions.Abdellah Nazeer
This document discusses radiological imaging techniques for evaluating various uterine lesions. It provides details on congenital uterine anomalies, pelvic inflammatory disease, endometriosis, adenomyosis, leiomyomas (fibroids), and endometrial polyps. Transvaginal ultrasound, CT, MRI, and hysterosalpingography are described as methods for diagnosing these conditions. Symptoms can include abnormal bleeding, pelvic pain, and infertility. Early diagnosis is important but can be challenging without invasive methods.
Pelvic inflammatory disease (PID) is an infection of the female upper genital tract that can cause long-term complications like chronic pelvic pain, infertility, and ectopic pregnancy if not promptly diagnosed and treated. It encompasses several conditions that may present asymptomatically or with mild to severe symptoms, making diagnosis difficult. Radiological imaging can help identify complications of PID like tubo-ovarian abscesses. The document then reviews various ovarian pathologies that may be identified on imaging such as cysts, tumors, and cancers of epithelial, stromal, and germ cell origin.
The document discusses adenomyosis, a benign condition where endometrial tissue grows within the uterine wall. It defines adenomyosis and describes associated symptoms like pelvic pain and abnormal bleeding. Diagnosis can only be confirmed by pathology after hysterectomy, though other imaging methods like ultrasound and MRI can provide clues. TVUS shows heterogeneous myometrial texture while MRI may detect increased thickness or consistency changes in the myometrium.
Presentation1, radiological imaging of endometrial carcinoma.Abdellah Nazeer
MRI is a valuable tool for assessing endometrial cancer by depicting tumor size, extension into the myometrium or parametrium, cervical invasion, and lymphadenopathy. It plays an important role in pre-operative planning by identifying high-risk features that may require lymph node dissection or adjuvant therapy. While endometrial cancer is surgically staged, MRI can accurately assess key features to guide treatment. It can also differentiate endometrial cancer from benign conditions like hyperplasia, adenomyosis, or fibroids.
This document provides information on endometrial carcinoma, cervical cancer, and uterine sarcomas as assessed by MRI. It begins with an overview of endometrial carcinoma histology and prognosis factors. It then details the MRI protocol for evaluating these cancers, including sequences used. The document describes the typical MRI appearances of these cancers and their stages according to FIGO classification. It concludes with sections on the MRI features of various uterine sarcomas, including leiomyosarcoma, endometrial stromal sarcoma, undifferentiated endometrial sarcoma, and adenosarcoma.
Presentation1.pptx, radiological imaging of female infertility.Abdellah Nazeer
This document discusses radiological imaging for evaluating female infertility. It begins by defining infertility and describing its prevalence. Imaging plays a key role in the diagnostic evaluation of infertility in women. Hysterosalpingography is often the initial study to evaluate fallopian tube patency. Additional imaging with ultrasound, MRI, or hysterography may be needed to further characterize any abnormalities. The document then discusses various causes of infertility related to the uterus, ovaries, fallopian tubes, and hormones. It describes imaging findings for specific conditions like endometriosis, polycystic ovaries, and Müllerian duct anomalies. The appropriate use of imaging modalities is important for directing patient care and management of infertility.
The document discusses the ultrasound and MRI appearance of the normal endometrium and various endometrial pathologies including polyps, hyperplasia, and carcinoma. It describes how the endometrium changes in appearance throughout the menstrual cycle in pre- and postmenopausal women. Endometrial polyps appear as focal masses or thickening on ultrasound and low signal masses on MRI. Hyperplasia is suggested by endometrial thickness over 10mm. Endometrial carcinoma demonstrates irregular thickening or an intracaity mass and can invade the myometrium or cervix in advanced stages. The 2009 FIGO staging system for endometrial cancer is outlined. MRI is useful for staging by evaluating myometrial
Leiomyoma, commonly known as uterine fibroids, are benign smooth muscle tumors of the uterus that are the most common tumors of the female pelvis. They occur most frequently in women during their childbearing years. While the exact causes are unknown, risk factors include high estrogen levels. Leiomyomas can be classified based on their location within the uterus as submucosal, subserosal, or intramural. Magnetic resonance imaging is the most accurate imaging technique for detecting and classifying leiomyomas. Treatment options depend on factors such as a patient's age, parity, symptoms, and the size and location of the fibroids and include conservative approaches, medications, uterine artery embolization,
This document provides rationales for questions from the 2007 ACR Diagnostic Radiology In-Training Exam related to ultrasound imaging. It discusses the correct answers and rationales for questions regarding various pathologies seen on ultrasound of the uterus, testes, kidneys, abdomen and fetal anatomy. Key details include identifying a cornual pregnancy based on its location, tubular ectasia of the rete testis in an older male, medullary nephrocalcinosis seen as echogenic renal pyramids, the left renal vein in the transverse abdominal image, and measuring fetal head circumference at the level of the thalami and cavum septi pellucidi.
This document summarizes several types of brain tumors:
Glioblastoma multiforme is the most malignant astrocytoma, most common glioma, located in the frontal lobe in ages 45-55, slightly more common in males. On CT it appears heterogeneous and lobulated with edema. On MRI it is hypointense on T1 and hyperintense on T2 with flow voids.
Medulloblastoma is the most common pediatric brain tumor in the cerebellar vermis in those under 10, peak ages 4-8, more common in males. On CT it appears solid or cystic with possible calcification. On MRI it is iso- to hypointense with surrounding edema.
This MRI report describes findings for a 45-year-old woman with chronic pelvic pain. The MRI showed a bulky uterus with diffuse wall thickening up to 13 mm, consistent with adenomyosis. A well-defined cyst was also seen in the right adnexa. Adenomyosis is a common condition where endometrial tissue grows in the uterine wall and can cause symptoms like heavy periods. The MRI is helpful for diagnosing adenomyosis based on junctional zone thickening of 12 mm or more. In this case, the findings of diffuse uterine wall thickening and enhancement support a diagnosis of adenomyosis with an additional right adnexal cyst.
1) The document discusses MRI features of common benign conditions of the female pelvis, including physiologic cysts, benign ovarian neoplasms, and benign pelvic disease processes.
2) Key MRI findings of physiologic cysts include the appearance of follicles as high signal intensity cysts under 1cm, corpus luteum cysts with thick irregular walls, and hemorrhagic cysts appearing high signal on T1-weighted images.
3) Common benign ovarian neoplasms discussed are dermoid cysts with signal intensity similar to fat, ovarian fibromas appearing similar to smooth muscle, and serous cystadenomas appearing as thin-walled fluid-filled cysts.
ULTRASOUND EXAMINATION OF Uterine and ovarian pathology by DR ABHIJIT R SINGHDrABHIJITRSINGH
Ultrasound is used to examine the uterus, ovaries, cervix and vagina to identify and characterize masses and pathologies. Common uterine pathologies seen on ultrasound include fibroids, which appear as well-defined hypoechoic masses that can be intramural, subserosal or submucosal. Endometrial polyps and cancer are also identified. Vaginal cysts such as Nabothian and Bartholin gland cysts appear as well-defined anechoic structures. Cervical pathologies include nabothian cysts, polyps and cancer, with cancer appearing heterogeneous and potentially showing increased vascularity on Doppler.
Ultrasound is useful for evaluating the causes of infertility. It can identify uterine, ovarian, and tubal abnormalities. For the uterus, ultrasound can detect congenital anomalies, infections, synechiae, lesions, scarring, and alterations in endometrial thickness and vascularity. Hysterosonography allows clear visualization of the uterine cavity and detection of polyps, fibroids, and synechiae. Adenomyosis is identified by heterogeneous myometrial texture, poorly defined endometrial borders, and cysts. Three-dimensional ultrasound helps diagnose uterine anomalies. Overall, ultrasound is a first-line, non-invasive tool for evaluating infertility.
Presentation1.pptx, ultrasound examination of the uterus and ovaries.Abdellah Nazeer
This document discusses ultrasound examination of the uterus and ovaries. It provides information on normal ultrasound anatomy and techniques for imaging the uterus longitudinally, transversely, and transvaginally. Common pathologies that can be identified include fibroids, polyps, cysts, cancers, and other masses. The roles of ultrasound include examining the pelvic organs, classifying masses, and guiding procedures. Indications for ultrasound and common ultrasound findings are summarized.
INVESTIGATIONS OF PAROTID GLAND TUMOUR.pptxPratik Jugnake
This document discusses investigations for parotid gland tumors. It describes imaging techniques like ultrasound, CT, MRI and PET-CT scans which are used to identify and characterize parotid tumors. Ultrasound can detect benign and malignant tumors but CT and MRI provide better images of deep lobe tumors. MRI is particularly useful for differentiating between benign and malignant tumors. Fine needle aspiration cytology and core needle biopsy are also used, with cytology being less invasive but biopsy providing more tissue for diagnosing cancers. The Milan system helps evaluate salivary gland cytology samples.
INVESTIGATIONS OF PAROTID GLAND TUMOUR.pptxPratik Jugnake
This document discusses investigations for parotid gland tumors. It describes imaging techniques like ultrasound, CT, MRI and PET-CT scans which are used to identify and characterize parotid tumors. Ultrasound can detect benign and malignant tumors but CT and MRI provide better images of deep lobe tumors. MRI is particularly useful for differentiating between benign and malignant tumors. Fine needle aspiration cytology and core needle biopsy are also used, with cytology being less invasive but biopsy providing more tissue for diagnosing cancers. The Milan system helps evaluate salivary gland cytology samples.
Presentation11, radiological imaging of ovarian torsion.Abdellah Nazeer
Ovarian torsion refers to the twisting of an ovary on its vascular pedicle, which can cut off its blood supply. It is a gynecological emergency that requires urgent surgery. Radiological imaging plays an important role in the diagnosis. Ultrasound is usually the initial imaging method, showing signs such as an enlarged ovary without blood flow. CT and MRI can further evaluate for complications like hemorrhage or infarction. Prompt diagnosis and treatment are needed to prevent ovarian necrosis from the loss of blood supply.
1. Ultrasound, CT, MRI, and other imaging modalities can be used to evaluate cancers of the female genital tract. Transvaginal ultrasound provides high quality images of the pelvic organs.
2. Imaging can detect masses in the uterus, ovaries, or other pelvic structures but often cannot distinguish between benign or malignant tumors. Features suggesting malignancy include solid components, thick septations, or invasion of surrounding tissues.
3. Common gynecologic cancers include those of the cervix, uterus, ovaries, vulva, and vagina. Leiomyomas (fibroids) are benign uterine tumors that can be identified on imaging. Sarcomas are rare malignant uterine tumors.
This document discusses adenomyosis and its relationship to infertility. It begins with background information on adenomyosis, including definitions, prevalence, symptoms, and theories of etiology. It then covers methods of diagnosis, including ultrasound, MRI, and hysteroscopy. Key diagnostic criteria on imaging studies are outlined. The document explores the association between adenomyosis and infertility, proposed mechanisms by which adenomyosis may impact fertility, and effects on outcomes of IVF treatment. While age is a confounding factor, studies suggest adenomyosis alone can increase rates of miscarriage and lower success of IVF. The document examines potential effects on utero-tubal transport, endometrial receptivity, implantation, and macrophage density.
The study of different presentations of breast lumps in radiographic. acta me...Sanjeev kumar Jain
This document discusses the use of ultrasound imaging in evaluating various breast lumps and pathologies. It provides pictorial examples of how different breast conditions appear on ultrasound scans. These include cysts, fibroadenomas, papillomas, lymph nodes, abscesses, fat necrosis, and different types of breast cancer. Ultrasound is found to be useful in characterizing breast lumps as solid or cystic and guiding biopsy procedures. While features can improve diagnosis, interobserver variability remains a limitation. An illustrated lexicon system helps standardize ultrasound findings. In summary, breast ultrasound is presented as a valuable tool for evaluating palpable lumps and abnormalities found on mammography.
Presentation1.pptx, radiological imaging of endometriosis.Abdellah Nazeer
Radiological imaging of endometriosis and adenomyosis.
Endometriosis and adenomyosis are common gynecological conditions that can be difficult to diagnose without imaging. MRI is the preferred imaging modality for evaluating these conditions. [1] Adenomyosis is characterized by ectopic endometrial glands within the myometrium, seen on MRI as junctional zone thickening over 12mm or ill-defined high T2 signal regions. [2] Endometriosis appears as powder-burn lesions, ovarian endometriomas or deep infiltrating nodules. Radiologists use MRI features like junctional zone measurements and high T1/T2 signals to diagnose and characterize
MRI of female pelvis as an atlas of imageBuiChienThang
This document provides an overview of MRI findings for various female pelvic pathologies. It describes the MRI protocol and normal zonal anatomy of the uterus. Key pathologies discussed include fibroids, endometrial carcinoma, cervical carcinoma, cervical cysts, pelvic inflammatory disease, and ovarian cysts/tumors. For each pathology, the document describes characteristic MRI features such as signal on T1 and T2-weighted images and enhancement patterns that aid diagnosis. Staging criteria for endometrial and cervical carcinomas are also presented. In summary, the document serves as an MRI-based atlas to identify and characterize common benign and malignant pelvic conditions.
This study investigated the use of diffusion-weighted MRI in differentiating between borderline epithelial ovarian tumours (BEOTs) and malignant epithelial ovarian tumours (MEOTs). The study found that BEOTs typically demonstrated low or moderate signal intensity in solid components on DW imaging, while MEOTs showed high signal intensity. The mean ADC value of solid components was also higher in BEOTs than MEOTs. An optimal ADC threshold of 1.039x10-3 mm2/s differentiated the two with high sensitivity and specificity. DW imaging and ADC values were thus useful for distinguishing BEOTs and MEOTs, which has implications for determining appropriate surgical approaches. Limitations included potential effects of free-bre
New microsoft office power point presentationRiyadhWaheed
This document discusses the role of 3D ultrasound in evaluating uterine diseases and anomalies. It begins by reviewing female reproductive tract embryology. It then describes the American Fertility Society's 7-class system for classifying Müllerian duct anomalies, including uterine agenesis, unicornuate uterus, bicornuate uterus, septate uterus, and DES exposure anomalies. It discusses how 3D ultrasound and MRI can be used to distinguish between septate and bicornuate anomalies. The document also discusses how 3D ultrasound can be used to measure endometrial volume and vascularity, which are important indicators of endometrial receptivity and pregnancy potential.
Seorang wanita 25 tahun didiagnosis dengan kanker serviks setelah dilakukan pemeriksaan. Seorang laki-laki 60 tahun mengeluh sesak dan kesakitan, hasil rontgen dadanya menunjukkan adanya masalah. Seorang wanita yang mudah lelah saat aktif menjalani pemeriksaan rontgen dan CT scan yang menemukan kalsifikasi di bagian kiri dada.
Leiomyoma, commonly known as uterine fibroids, are benign smooth muscle tumors of the uterus that are the most common tumors of the female pelvis. They occur most frequently in women during their childbearing years. While the exact causes are unknown, risk factors include high estrogen levels. Leiomyomas can be classified based on their location within the uterus as submucosal, subserosal, or intramural. Magnetic resonance imaging is the most accurate imaging technique for detecting and classifying leiomyomas. Treatment options depend on factors such as a patient's age, parity, symptoms, and the size and location of the fibroids and include conservative approaches, medications, uterine artery embolization,
This document provides rationales for questions from the 2007 ACR Diagnostic Radiology In-Training Exam related to ultrasound imaging. It discusses the correct answers and rationales for questions regarding various pathologies seen on ultrasound of the uterus, testes, kidneys, abdomen and fetal anatomy. Key details include identifying a cornual pregnancy based on its location, tubular ectasia of the rete testis in an older male, medullary nephrocalcinosis seen as echogenic renal pyramids, the left renal vein in the transverse abdominal image, and measuring fetal head circumference at the level of the thalami and cavum septi pellucidi.
This document summarizes several types of brain tumors:
Glioblastoma multiforme is the most malignant astrocytoma, most common glioma, located in the frontal lobe in ages 45-55, slightly more common in males. On CT it appears heterogeneous and lobulated with edema. On MRI it is hypointense on T1 and hyperintense on T2 with flow voids.
Medulloblastoma is the most common pediatric brain tumor in the cerebellar vermis in those under 10, peak ages 4-8, more common in males. On CT it appears solid or cystic with possible calcification. On MRI it is iso- to hypointense with surrounding edema.
This MRI report describes findings for a 45-year-old woman with chronic pelvic pain. The MRI showed a bulky uterus with diffuse wall thickening up to 13 mm, consistent with adenomyosis. A well-defined cyst was also seen in the right adnexa. Adenomyosis is a common condition where endometrial tissue grows in the uterine wall and can cause symptoms like heavy periods. The MRI is helpful for diagnosing adenomyosis based on junctional zone thickening of 12 mm or more. In this case, the findings of diffuse uterine wall thickening and enhancement support a diagnosis of adenomyosis with an additional right adnexal cyst.
1) The document discusses MRI features of common benign conditions of the female pelvis, including physiologic cysts, benign ovarian neoplasms, and benign pelvic disease processes.
2) Key MRI findings of physiologic cysts include the appearance of follicles as high signal intensity cysts under 1cm, corpus luteum cysts with thick irregular walls, and hemorrhagic cysts appearing high signal on T1-weighted images.
3) Common benign ovarian neoplasms discussed are dermoid cysts with signal intensity similar to fat, ovarian fibromas appearing similar to smooth muscle, and serous cystadenomas appearing as thin-walled fluid-filled cysts.
ULTRASOUND EXAMINATION OF Uterine and ovarian pathology by DR ABHIJIT R SINGHDrABHIJITRSINGH
Ultrasound is used to examine the uterus, ovaries, cervix and vagina to identify and characterize masses and pathologies. Common uterine pathologies seen on ultrasound include fibroids, which appear as well-defined hypoechoic masses that can be intramural, subserosal or submucosal. Endometrial polyps and cancer are also identified. Vaginal cysts such as Nabothian and Bartholin gland cysts appear as well-defined anechoic structures. Cervical pathologies include nabothian cysts, polyps and cancer, with cancer appearing heterogeneous and potentially showing increased vascularity on Doppler.
Ultrasound is useful for evaluating the causes of infertility. It can identify uterine, ovarian, and tubal abnormalities. For the uterus, ultrasound can detect congenital anomalies, infections, synechiae, lesions, scarring, and alterations in endometrial thickness and vascularity. Hysterosonography allows clear visualization of the uterine cavity and detection of polyps, fibroids, and synechiae. Adenomyosis is identified by heterogeneous myometrial texture, poorly defined endometrial borders, and cysts. Three-dimensional ultrasound helps diagnose uterine anomalies. Overall, ultrasound is a first-line, non-invasive tool for evaluating infertility.
Presentation1.pptx, ultrasound examination of the uterus and ovaries.Abdellah Nazeer
This document discusses ultrasound examination of the uterus and ovaries. It provides information on normal ultrasound anatomy and techniques for imaging the uterus longitudinally, transversely, and transvaginally. Common pathologies that can be identified include fibroids, polyps, cysts, cancers, and other masses. The roles of ultrasound include examining the pelvic organs, classifying masses, and guiding procedures. Indications for ultrasound and common ultrasound findings are summarized.
INVESTIGATIONS OF PAROTID GLAND TUMOUR.pptxPratik Jugnake
This document discusses investigations for parotid gland tumors. It describes imaging techniques like ultrasound, CT, MRI and PET-CT scans which are used to identify and characterize parotid tumors. Ultrasound can detect benign and malignant tumors but CT and MRI provide better images of deep lobe tumors. MRI is particularly useful for differentiating between benign and malignant tumors. Fine needle aspiration cytology and core needle biopsy are also used, with cytology being less invasive but biopsy providing more tissue for diagnosing cancers. The Milan system helps evaluate salivary gland cytology samples.
INVESTIGATIONS OF PAROTID GLAND TUMOUR.pptxPratik Jugnake
This document discusses investigations for parotid gland tumors. It describes imaging techniques like ultrasound, CT, MRI and PET-CT scans which are used to identify and characterize parotid tumors. Ultrasound can detect benign and malignant tumors but CT and MRI provide better images of deep lobe tumors. MRI is particularly useful for differentiating between benign and malignant tumors. Fine needle aspiration cytology and core needle biopsy are also used, with cytology being less invasive but biopsy providing more tissue for diagnosing cancers. The Milan system helps evaluate salivary gland cytology samples.
Presentation11, radiological imaging of ovarian torsion.Abdellah Nazeer
Ovarian torsion refers to the twisting of an ovary on its vascular pedicle, which can cut off its blood supply. It is a gynecological emergency that requires urgent surgery. Radiological imaging plays an important role in the diagnosis. Ultrasound is usually the initial imaging method, showing signs such as an enlarged ovary without blood flow. CT and MRI can further evaluate for complications like hemorrhage or infarction. Prompt diagnosis and treatment are needed to prevent ovarian necrosis from the loss of blood supply.
1. Ultrasound, CT, MRI, and other imaging modalities can be used to evaluate cancers of the female genital tract. Transvaginal ultrasound provides high quality images of the pelvic organs.
2. Imaging can detect masses in the uterus, ovaries, or other pelvic structures but often cannot distinguish between benign or malignant tumors. Features suggesting malignancy include solid components, thick septations, or invasion of surrounding tissues.
3. Common gynecologic cancers include those of the cervix, uterus, ovaries, vulva, and vagina. Leiomyomas (fibroids) are benign uterine tumors that can be identified on imaging. Sarcomas are rare malignant uterine tumors.
This document discusses adenomyosis and its relationship to infertility. It begins with background information on adenomyosis, including definitions, prevalence, symptoms, and theories of etiology. It then covers methods of diagnosis, including ultrasound, MRI, and hysteroscopy. Key diagnostic criteria on imaging studies are outlined. The document explores the association between adenomyosis and infertility, proposed mechanisms by which adenomyosis may impact fertility, and effects on outcomes of IVF treatment. While age is a confounding factor, studies suggest adenomyosis alone can increase rates of miscarriage and lower success of IVF. The document examines potential effects on utero-tubal transport, endometrial receptivity, implantation, and macrophage density.
The study of different presentations of breast lumps in radiographic. acta me...Sanjeev kumar Jain
This document discusses the use of ultrasound imaging in evaluating various breast lumps and pathologies. It provides pictorial examples of how different breast conditions appear on ultrasound scans. These include cysts, fibroadenomas, papillomas, lymph nodes, abscesses, fat necrosis, and different types of breast cancer. Ultrasound is found to be useful in characterizing breast lumps as solid or cystic and guiding biopsy procedures. While features can improve diagnosis, interobserver variability remains a limitation. An illustrated lexicon system helps standardize ultrasound findings. In summary, breast ultrasound is presented as a valuable tool for evaluating palpable lumps and abnormalities found on mammography.
Presentation1.pptx, radiological imaging of endometriosis.Abdellah Nazeer
Radiological imaging of endometriosis and adenomyosis.
Endometriosis and adenomyosis are common gynecological conditions that can be difficult to diagnose without imaging. MRI is the preferred imaging modality for evaluating these conditions. [1] Adenomyosis is characterized by ectopic endometrial glands within the myometrium, seen on MRI as junctional zone thickening over 12mm or ill-defined high T2 signal regions. [2] Endometriosis appears as powder-burn lesions, ovarian endometriomas or deep infiltrating nodules. Radiologists use MRI features like junctional zone measurements and high T1/T2 signals to diagnose and characterize
MRI of female pelvis as an atlas of imageBuiChienThang
This document provides an overview of MRI findings for various female pelvic pathologies. It describes the MRI protocol and normal zonal anatomy of the uterus. Key pathologies discussed include fibroids, endometrial carcinoma, cervical carcinoma, cervical cysts, pelvic inflammatory disease, and ovarian cysts/tumors. For each pathology, the document describes characteristic MRI features such as signal on T1 and T2-weighted images and enhancement patterns that aid diagnosis. Staging criteria for endometrial and cervical carcinomas are also presented. In summary, the document serves as an MRI-based atlas to identify and characterize common benign and malignant pelvic conditions.
This study investigated the use of diffusion-weighted MRI in differentiating between borderline epithelial ovarian tumours (BEOTs) and malignant epithelial ovarian tumours (MEOTs). The study found that BEOTs typically demonstrated low or moderate signal intensity in solid components on DW imaging, while MEOTs showed high signal intensity. The mean ADC value of solid components was also higher in BEOTs than MEOTs. An optimal ADC threshold of 1.039x10-3 mm2/s differentiated the two with high sensitivity and specificity. DW imaging and ADC values were thus useful for distinguishing BEOTs and MEOTs, which has implications for determining appropriate surgical approaches. Limitations included potential effects of free-bre
New microsoft office power point presentationRiyadhWaheed
This document discusses the role of 3D ultrasound in evaluating uterine diseases and anomalies. It begins by reviewing female reproductive tract embryology. It then describes the American Fertility Society's 7-class system for classifying Müllerian duct anomalies, including uterine agenesis, unicornuate uterus, bicornuate uterus, septate uterus, and DES exposure anomalies. It discusses how 3D ultrasound and MRI can be used to distinguish between septate and bicornuate anomalies. The document also discusses how 3D ultrasound can be used to measure endometrial volume and vascularity, which are important indicators of endometrial receptivity and pregnancy potential.
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Seorang wanita 25 tahun didiagnosis dengan kanker serviks setelah dilakukan pemeriksaan. Seorang laki-laki 60 tahun mengeluh sesak dan kesakitan, hasil rontgen dadanya menunjukkan adanya masalah. Seorang wanita yang mudah lelah saat aktif menjalani pemeriksaan rontgen dan CT scan yang menemukan kalsifikasi di bagian kiri dada.
This document contains information on grading various types of organ injuries including liver, spleen, pancreas, kidney, ureter, bladder, and urethra injuries using the AAST grading system. It also provides information on staging various cancers such as nasopharyngeal carcinoma, sinonasal carcinoma, lung cancer, pancreatic cancer, renal cell carcinoma, transitional cell carcinoma, bladder carcinoma, endometrial carcinoma, cervical cancer, ovarian cancer, and colorectal cancer using different staging systems. Additionally, it mentions lymphoma.
This document discusses neck trauma, providing information on epidemiology, mechanisms of injury, anatomical structures at risk, diagnostic evaluation, and management. It examines the spectrum of neck injuries, defines the three zones of the neck, and identifies nursing considerations for patients with neck trauma.
Dokumen tersebut berisi soal-soal latihan mengenai deskripsi dan diagnosa berbagai kelainan yang tampak pada pemeriksaan radiologi untuk berbagai pasien dengan keluhan klinis yang berbeda, seperti sesak nafas, nyeri perut, trauma, dan lainnya.
Classic signs in gastrointestinal radiology describes several classic imaging signs seen in gastrointestinal diseases. The comb sign represents engorged blood vessels seen in Crohn's disease. The target sign shows bowel wall enhancement in a target-like pattern seen in Crohn's disease and other conditions. Several other signs are described that resemble everyday objects when seen on imaging, including the coiled spring sign, arrowhead sign, and thumbprint sign seen in various gastrointestinal diseases. Understanding these classic radiological signs aids in diagnosis and communication between radiologists and clinicians.
This document provides an overview of fibro-osseous lesions and focuses on fibrous dysplasia. It discusses the classification, etiology, clinical features, radiographic features, histologic features, treatment and prognosis of fibrous dysplasia. Specifically, it notes that fibrous dysplasia is a benign skeletal developmental anomaly caused by a mutation in the GNAS1 gene. It can present as monostotic, polyostotic or craniofacial lesions and is characterized radiographically by an orange peel or ground glass appearance. Histologically, it demonstrates irregular bony trabeculae within a cellular fibrous connective tissue stroma. Treatment involves surgery or bisphosphonates and the prognosis is generally good though
dr. Nani PPT (Kasus) Embolisasi pada Infantil Hemangioma (1).pptxssuser86266b
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(1) Dokumen tersebut membahas tentang embolisasi pada hemangioma infantil pada seorang bayi laki-laki berusia 9 bulan, (2) MRI menunjukkan gambaran hemangioma infantil di ketiak kanan, (3) Embolisasi dilakukan dengan menginjeksi glue dan lipiodol ke arteri pemberi darah tumor.
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This document discusses the evaluation and differential diagnosis of acute unilateral limb swelling using imaging studies. It notes that the differential can include deep vein thrombosis (DVT), cellulitis, trauma, joint effusions, bone issues like osteomyelitis or fractures, and muscle/tendon problems. Doppler ultrasound is highly sensitive and specific for diagnosing DVT and is recommended as the initial imaging test to evaluate the veins and exclude DVT. CT or MRI may be needed to further characterize abnormalities and assess deep tissues like muscles or bones. The document then reviews the appearance and diagnostic approach for various potential etiologies based on anatomical location.
1. Abdominal Pain MARS 2.0 - dr. Siswidiyati, Sp.Rad.pptxssuser86266b
This document provides guidance on imaging strategies for evaluating abdominal pain. It discusses:
1. Sonography and CT can accurately and rapidly evaluate patients with acute abdominal pain by confirming or excluding common diseases like appendicitis and cholecystitis.
2. The recommended radiology approach is to first focus on confirming or ruling out the most likely diagnosis based on symptoms, then screen the whole abdomen for signs of pathology.
3. Key imaging findings for common conditions are discussed, including gallbladder wall thickening for cholecystitis and appendiceal diameter for appendicitis. Imaging also helps evaluate complications like abscesses.
4. Bowel obstruction is suggested by findings like dilated bowel loops and air
dr. Adnan (Referat) Gambaran MRI Kanker Prostat.pdfssuser86266b
Dokumen tersebut merangkum teknik dan gambaran MRI untuk kanker prostat. MRI prostat membutuhkan kekuatan magnet minimal 1.5 Tesla dan penggunaan coil endorektal untuk kualitas gambar yang lebih baik. Pemeriksaan konvensional menggunakan T2-WI dan T1-WI yang menunjukkan intensitas rendah pada kanker prostat. Namun, beberapa kanker justru tampak isointens sehingga diperlukan teknik fungsional seperti DWI, DCE
Rasamanikya is a excellent preparation in the field of Rasashastra, it is used in various Kushtha Roga, Shwasa, Vicharchika, Bhagandara, Vatarakta, and Phiranga Roga. In this article Preparation& Comparative analytical profile for both Formulationon i.e Rasamanikya prepared by Kushmanda swarasa & Churnodhaka Shodita Haratala. The study aims to provide insights into the comparative efficacy and analytical aspects of these formulations for enhanced therapeutic outcomes.
Title: Sense of Taste
Presenter: Dr. Faiza, Assistant Professor of Physiology
Qualifications:
MBBS (Best Graduate, AIMC Lahore)
FCPS Physiology
ICMT, CHPE, DHPE (STMU)
MPH (GC University, Faisalabad)
MBA (Virtual University of Pakistan)
Learning Objectives:
Describe the structure and function of taste buds.
Describe the relationship between the taste threshold and taste index of common substances.
Explain the chemical basis and signal transduction of taste perception for each type of primary taste sensation.
Recognize different abnormalities of taste perception and their causes.
Key Topics:
Significance of Taste Sensation:
Differentiation between pleasant and harmful food
Influence on behavior
Selection of food based on metabolic needs
Receptors of Taste:
Taste buds on the tongue
Influence of sense of smell, texture of food, and pain stimulation (e.g., by pepper)
Primary and Secondary Taste Sensations:
Primary taste sensations: Sweet, Sour, Salty, Bitter, Umami
Chemical basis and signal transduction mechanisms for each taste
Taste Threshold and Index:
Taste threshold values for Sweet (sucrose), Salty (NaCl), Sour (HCl), and Bitter (Quinine)
Taste index relationship: Inversely proportional to taste threshold
Taste Blindness:
Inability to taste certain substances, particularly thiourea compounds
Example: Phenylthiocarbamide
Structure and Function of Taste Buds:
Composition: Epithelial cells, Sustentacular/Supporting cells, Taste cells, Basal cells
Features: Taste pores, Taste hairs/microvilli, and Taste nerve fibers
Location of Taste Buds:
Found in papillae of the tongue (Fungiform, Circumvallate, Foliate)
Also present on the palate, tonsillar pillars, epiglottis, and proximal esophagus
Mechanism of Taste Stimulation:
Interaction of taste substances with receptors on microvilli
Signal transduction pathways for Umami, Sweet, Bitter, Sour, and Salty tastes
Taste Sensitivity and Adaptation:
Decrease in sensitivity with age
Rapid adaptation of taste sensation
Role of Saliva in Taste:
Dissolution of tastants to reach receptors
Washing away the stimulus
Taste Preferences and Aversions:
Mechanisms behind taste preference and aversion
Influence of receptors and neural pathways
Impact of Sensory Nerve Damage:
Degeneration of taste buds if the sensory nerve fiber is cut
Abnormalities of Taste Detection:
Conditions: Ageusia, Hypogeusia, Dysgeusia (parageusia)
Causes: Nerve damage, neurological disorders, infections, poor oral hygiene, adverse drug effects, deficiencies, aging, tobacco use, altered neurotransmitter levels
Neurotransmitters and Taste Threshold:
Effects of serotonin (5-HT) and norepinephrine (NE) on taste sensitivity
Supertasters:
25% of the population with heightened sensitivity to taste, especially bitterness
Increased number of fungiform papillae
ABDOMINAL TRAUMA in pediatrics part one.drhasanrajab
Abdominal trauma in pediatrics refers to injuries or damage to the abdominal organs in children. It can occur due to various causes such as falls, motor vehicle accidents, sports-related injuries, and physical abuse. Children are more vulnerable to abdominal trauma due to their unique anatomical and physiological characteristics. Signs and symptoms include abdominal pain, tenderness, distension, vomiting, and signs of shock. Diagnosis involves physical examination, imaging studies, and laboratory tests. Management depends on the severity and may involve conservative treatment or surgical intervention. Prevention is crucial in reducing the incidence of abdominal trauma in children.
Muktapishti is a traditional Ayurvedic preparation made from Shoditha Mukta (Purified Pearl), is believed to help regulate thyroid function and reduce symptoms of hyperthyroidism due to its cooling and balancing properties. Clinical evidence on its efficacy remains limited, necessitating further research to validate its therapeutic benefits.
Basavarajeeyam is an important text for ayurvedic physician belonging to andhra pradehs. It is a popular compendium in various parts of our country as well as in andhra pradesh. The content of the text was presented in sanskrit and telugu language (Bilingual). One of the most famous book in ayurvedic pharmaceutics and therapeutics. This book contains 25 chapters called as prakaranas. Many rasaoushadis were explained, pioneer of dhatu druti, nadi pareeksha, mutra pareeksha etc. Belongs to the period of 15-16 century. New diseases like upadamsha, phiranga rogas are explained.
Integrating Ayurveda into Parkinson’s Management: A Holistic ApproachAyurveda ForAll
Explore the benefits of combining Ayurveda with conventional Parkinson's treatments. Learn how a holistic approach can manage symptoms, enhance well-being, and balance body energies. Discover the steps to safely integrate Ayurvedic practices into your Parkinson’s care plan, including expert guidance on diet, herbal remedies, and lifestyle modifications.
micro teaching on communication m.sc nursing.pdfAnurag Sharma
Microteaching is a unique model of practice teaching. It is a viable instrument for the. desired change in the teaching behavior or the behavior potential which, in specified types of real. classroom situations, tends to facilitate the achievement of specified types of objectives.
Local Advanced Lung Cancer: Artificial Intelligence, Synergetics, Complex Sys...Oleg Kshivets
Overall life span (LS) was 1671.7±1721.6 days and cumulative 5YS reached 62.4%, 10 years – 50.4%, 20 years – 44.6%. 94 LCP lived more than 5 years without cancer (LS=2958.6±1723.6 days), 22 – more than 10 years (LS=5571±1841.8 days). 67 LCP died because of LC (LS=471.9±344 days). AT significantly improved 5YS (68% vs. 53.7%) (P=0.028 by log-rank test). Cox modeling displayed that 5YS of LCP significantly depended on: N0-N12, T3-4, blood cell circuit, cell ratio factors (ratio between cancer cells-CC and blood cells subpopulations), LC cell dynamics, recalcification time, heparin tolerance, prothrombin index, protein, AT, procedure type (P=0.000-0.031). Neural networks, genetic algorithm selection and bootstrap simulation revealed relationships between 5YS and N0-12 (rank=1), thrombocytes/CC (rank=2), segmented neutrophils/CC (3), eosinophils/CC (4), erythrocytes/CC (5), healthy cells/CC (6), lymphocytes/CC (7), stick neutrophils/CC (8), leucocytes/CC (9), monocytes/CC (10). Correct prediction of 5YS was 100% by neural networks computing (error=0.000; area under ROC curve=1.0).
Adhd Medication Shortage Uk - trinexpharmacy.comreignlana06
The UK is currently facing a Adhd Medication Shortage Uk, which has left many patients and their families grappling with uncertainty and frustration. ADHD, or Attention Deficit Hyperactivity Disorder, is a chronic condition that requires consistent medication to manage effectively. This shortage has highlighted the critical role these medications play in the daily lives of those affected by ADHD. Contact : +1 (747) 209 – 3649 E-mail : sales@trinexpharmacy.com
2. INTRODUCTION
Benign uterine diseases
(Adenomyosis, leiomyomas)
are common gynecologic
conditions affecting women
of all ages
USG : first-line imaging
technique
MRI : the most accurate
tool in lesion diagnosis
and patient management
Discusses typical and
atypical MRI findings
of adenomyosis and
leiomyomas and
therapeutic options
3. MAGNETIC RESONANCE IMAGING PROTOCOL
Patient Preparation
Fasting and use antiperistaltic agent (Hyoscine Butylpromide
or glucagon)
A moderately full bladder
4. IMAGING PROTOCOL
High-resolution thin-section images acquired at 1.5 T or 3.0 T are recommended.
T2WI location of the lesion relative to the endometrial cavity
T1WI (with/without FS) presence of fat or blood contents and can be used to detect the
presence of lymph nodes and bone marrow abnormalities
Large-FOVT1WI/T2WI secondary signs of pelvic mass effect, such as hydronephrosis,
and malignant disease, such as lymph nodes or peritoneal
carcinomatosis
Contrast-enhanced T1WI FS characterization, vascularization, and its differentiation from an
adnexal mass
Dynamic contrast injection/
MR angiography
uterine artery anatomy and collateral gonadal arterial supply
DWI characterization and distinction between leiomyoma and
leiomyosarcoma
5. LEIOMYOMAS
EPIDEMIOLOGY, PATHOPHYSIOLOGY
The most common, 20%-30% of reproductive-aged women
Unknown cause composed of multiple layers of smooth muscle
fascicles and fibrous connective tissue anchored in the muscular
wall of the uterus
Solitary or, most frequently, multiple
May be asymptomatic, 20%-50% with menorrhagia,
dysmenorrhea, urinary frequency, pelvic and back pain, and
dyspareunia
6. LOCATION
Leiomyoma FIGO classification system according to location. The leiomyoma FIGO
classification: 0, pedunculated intracavitary; 1, submucosal less than 50% intramural; 2,
submucosal greater than or equal to 50% intramural; 3, contacts endometrium, 100% intramural;
4, intramural; 5, subserosal greater than or equal to 50% intramural; 6, subserosal less than 50%
intramural; 7, subserosal pedunculated; 8, other (specify; eg, cervical, parasitic)
7. Unusual locations
diffuse peritoneal
leiomyomatosis
multiple lesions along the
peritoneal surfaces
iatrogenic dissemination
Intravenous
leiomyomatosis
aggressive intravascular growth
pattern within intrauterine and
systemic veins
benign metastasizing
leiomyoma
8. IMAGING FEATURES
Ultrasonography
Well-defined mass, often shadowing at the margin and/or producing
internal linear shadowing.
Varies from hypoechoic to hyperechoic in relation to the
myometrium.
Dystrophic calcifications can be seen particularly in postmenopausal
women.
On color Doppler US, circumferential blood flow around the lesion is
often seen
9. Magnetic resonance imaging
Sensitivities and specificities of 94.1% and 68.7%, respectively, for uterine leiomyomas
10. Isointense signal intensity on T1-weighted image (C), and homogeneous contrast enhancement
(F). The blackout phenomenon is shown, with no signs of restricted diffusion with low signal
intensity on DW image (b = 1000) (D) and corresponding ADC map (E).
Myometrial lesion with
endometrial contact (arrows) in
keeping with a FIGO 3
leiomyoma. Nondegenerated
leiomyoma appears as a well-
defined lesion with hypointense
signal intensity on T2-weighted
images related to the outer
myometrium (A,B)
SagittalT2 AxialT2 AxialT1
Axial DWI ADC AxialT1 FS Contrast
Nondegenerated
leiomyoma
11. SagittalT2 AxialT2
A well-delineated lesion (arrow)
of intermediate to high signal
intensity without T2 dark areas
(A, B). Isointense lesion without
hemorrhage (C, arrow). (D)
DWI (b = 1000) shows high
signal intensity (arrow) with
restriction on (E) corresponding
map (arrow). (F) avid and
heterogeneous enhancement
without necrosis (arrow).
Axial obliqueT1
Axial DWI ADC Axial obliqueT1 FS C
The absence of hemorrhage and necrosis, T2 dark signal, and
the presence of well-defined border favor a cellular leiomyoma
rather than leiomyosarcoma; this was confirmed histologically.
Cellular
leiomyoma
12. Different types of leiomyoma degeneration
Hyaline degeneration
(A) Axial T2-weighted image and (B) contrast-enhanced axial T1-weighted
fat-saturated image show a leiomyoma (arrow) with hypointense signal
intensity on T2-weighted image and poor enhancement after gadolinium
injection, suggesting hyaline degeneration.
T2 WI T1-WI FS+C
13. CYSTIC DEGENERATION
(C) Axial T2-weighted image and (D) sagittal T2-weighted image showa
large,well-defined cystic lesion (arrow) with high T2 signal intensity,
consistent with cystic leiomyoma because of its uterine origin (claw sign).
14. MYXOID DEGENERATION
(E) Sagittal T2-weighted fat-
saturated image and (F) contrast-
enhanced sagittal T1-weighted fat-
saturated image show a
leiomyoma (arrow) presenting
areas with high signal intensity on
T2-weighted image and
enhancement after gadolinium
injection, with the exception of the
nonenhancing mucinous lakes,
suggesting a myxoid leiomyoma
15. HEMORRHAGIC DEGENERATION
(G) Axial T1-weighted fat-
saturated image and (H)
axial T2 FS show a left
parauterine lesion (white
arrow) with a component
of very high signal
intensity on T1-weighted
image and low signal
intensity on T2-weighted
image, suggesting
intralesional hemorrhage.
The lesion is a hemorrhagic subserosal pedunculated leiomyoma
(MR imaging FIGO 7) with enlarged and tortuous vessel (black
arrow, H) that extends from the uterus to the mass (bridging
vessel sign), indicating the uterine origin of the lesion.
16. PITFALLSTO AVOID ON MAGNETIC RESONANCE IMAGING
1. Distinction between an ovarian mass and a uterine mass
Axial T2-weighted image shows a well-
defined Left parauterine mass with low
signal intensity that could resemble
either a uterine leiomyoma or ovarian
fibroma.
In this case, the left ovary (black arrow)
is normal and separate fromthemass.
Enlarged and tortuous vessels
extended from the uterus to supply the
mass (white arrows, bridging vessels
sign), suggesting the diagnosis of
uterine leiomyoma.
17. 2. FOCAL MYOMETRIAL CONTRACTIONS
(A) Sagittal and (B) axial T2-W FS
images. Axial T2-WI shows
hypointense bands perpendicular
to the junctional zone (JZ) in the
anterior myometrium (arrows, B).
This finding was absent on
previous sagittal T2-weighted
image that shows normal uterus
with thin and distinct JZ (arrow, A),
confirming the diagnosis of
transient myometrial contraction.
18. 3. ENDOMETRIAL POLYP
Submucosal leiomyoma may be mistaken for an endometrial polyp
Polyps have heterogeneous or high signal onT2WI, in contrast with
pedunculated submucosal leiomyomas, which are low signal onT2WI and
have a stalk that arises from the myometrium
20. 5. LEIOMYOSARCOMAS
Axial T2-weighted image shows dark T2
area (arrow, A) and ill-defined border.
Hemorrhage is seen on the axial T1-
weighted image (arrow, B). (C) Axial
oblique DW image (b = 1000) shows
high signal intensity (arrow). (D)
Contrast-enhanced axial oblique T1-
weighted fat-saturated image shows
heterogeneous enhancement with
central necrosis (arrow).
These combined features are
suggestive of leiomyosarcoma, which
was confirmed histologically.
AxialT2 AxialT1
Axial DWI AxialT1 FS + C
21. The role of MR imaging in differentiating leiomyoma and uterine sarcoma
22. TREATMENT OPTIONS
▪ Asymptomatic leiomyomas do not require treatment
▪ Oral contraceptives or gonadotropin-releasing hormone (GnRH) agonists
may be used to reduce menstrual bleeding associated with leiomyomas, may
also reduce the size of leiomyomas.
23. ▪ Women with refractory abnormal bleeding or those experiencing bulk
symptoms, such as pelvic fullness, constipation, or urinary symptoms, may
be eligible for surgical management :
▪ Uterine sparing myomectomy : 3 or fewer dominant symptomatic
leiomyomas less than 8 cm in diameter
▪ Hysteroscopic myomectomy : submucosal leiomyomas predominantly
intracavitary, less than 4 cm in size, and have at least 5 mm of intact
myometrium overlying the leiomyoma
24. UAE is a minimally invasive uterine-sparing treatment option for
leiomyomas resulting in abnormal bleeding, anemia, and/or bulk
symptoms.
UAE is an alternative to myomectomy, but, unlike myomectomy, it is also
useful in patients with multiple (>3) and large (>10 cm) leiomyomas.
UAE offers the opportunity to preserve fertility, improves or eliminates
bulk symptoms and bleeding, is durable, and has a low complication rate.
There is a roughly 10% to 15% treatment failure rate in which patients
require additional treatment with hysterectomy, myomectomy, or repeat
UAE.
25. ADENOMYOSIS
Epidemiology, Clinical Symptoms, and Pathophysiology
• Ectopic endometrial glands and stroma in the myometrium more than 2.5
mm from the endometrium-myometrium interface
• 1/3 are asymptomatic, symptoms nonspecific : dysmenorrhea, menorrhagia,
and abnormal vaginal bleeding
• Associated with female infertility, overlapping pathophysiology and
association with endometriosis
• Cause of adenomyosis is still unclear : exposure to estrogen, prior uterine
surgery, and parity are known risk factors
26. ULTRASONOGRAPHY IMAGING FEATURES
Myometrial heterogeneity with thin linear shadowing (venetian blinds)
alternating with increased echogenicity, globular uterine enlargement,
asymmetric thickening of the myometrium (pseudowidening sign), and
isolated or clustered small anechoic cysts
May be similar to uterine leiomyoma
Leiomyomas : usually have a well-defined border and peripheral color flow
Adenomyomas : illdefined, show less mass effect, and have diffuse and
central color flow
27. MAGNETIC RESONANCE IMAGING FEATURES
Sensitivity of 46.1%, specificity of 99.2%, and positive predictive value of 92.3%
(A) Classic features of
adenomyosis: subendometrial
cysts and diffuse thickening
(orange arrow) of the JZ.
(B) enlarged uterus with the
classic MRI appearance of
adenomyosis as thickening of the
JZ, particularly of the anterior
myometrium (orange arrow) with
multiple foci with high T2 signal
(white arrows).
(C) (D) Show a high-T2 and high-
T1 focus within the anterior
myometrium (arrow, C, D) caused
by hemorrhagic content.
SagittalT2
AxialT2 AxialT1
28. SUBTYPES OF ADENOMYOSIS
(A) The different : adenomyoma and
leioemyoma. An adenomyoma is T2
dark with internal bright foci caused by
endometrial glands, whereas a typical
leiomyoma is homogeneously dark
with a bright peripheral rim caused by
perilesional edema that generally
causes more adjacent mass effect than
adenomyoma.
(B) Show an ill-defined, low-signal
intensity mass with embedded
hyperintense foci in the posterior
myometrium (arrow, B) suggesting an
adenomyoma.
1.Adenomyoma
SagittalT2
29. (C) a well-defined, low-signal-intensity mass with embedded hyperintense foci bulging into the
endometrium (arrow, C) suggesting a subendometrial adenomyoma.
(D) an enlarged uterus, with the coexistence of an adenomyoma, as ill-defined hypointense
masslike lesion with embedded hyperintense punctate foci in the posterior myometrium (white
arrow), and a leiomyoma as well defined very hypointense mass in the anterior myometrium
causing adjacent mass effect (black arrow)
Axial obliqueT2-WI SagittalT2-WI
30. 2. HEMORRHAGIC CYSTIC ADENOMYOSIS
(A) Diffuse thickening of the JZ
and a single intramural focus of
high signal intensity in the
anterior myometrium (arrow).
(B, C) The cystlike focus is
better seen on (B) and (C),
characterized by T1 and T2 high
signal (arrow, B, C), confirming
hemorrhagic content.
SagittalT2 FS AxialT1-WI
AxialT2 WI
31. • External adenomyosis : outer part of the uterus, most likely in the
posterior myometrium, disrupting the serosa but not affecting the JZ,
usually associated with deep endometriosis. On MR imaging, it appears as
an ill-defined subserosal posterior T2-hypointense mass/pseudomass and
may containT2-hyperintense small cystic areas.
• Adenomyomatous polyp or polypoid adenomyoma : polypoid mass in the
lower uterine endometrium or endocervix, and accounts for about 2% of
all endometrial polyps. On MR imaging, it is a hypointense polypoid mass
associated withT2- hyperintense foci.
32. MAGNETIC RESONANCE IMAGING DIFFERENTIAL DIAGNOSIS
1. Cyclic physiologic changes of the uterus (pseudothickening of the JZ):
hormone dependent and changes according to the menstrual cycle. not
be performed during menstruation
2. Nonmeasurable JZ: postmenopausal patients and in women using
contraceptive drugs.
3. Myometrial contractions
33. 4. Endometrial cancer : adenomyosis can be seen in 20% of patients with
endometrial cancer. DWI may help to define the depth of myometrial
invasion; adenomyosis does not restrict diffusion, whereas endometrial
cancer does (Fig. 13)
5. Leiomyoma : traditionally, adenomyomas present as a T2 hypointense
mass with ill-defined borders, minimal mass effect, and with multiple bright
foci. In contrast, leiomyoma, besides also being T2 hypointense, also has a
well-defined border, adjacent mass effect, and large vessels surrounding the
lesion (see Fig. 10)
34. Pseudowidening of the JZ with coexisting
endometrial cancer. (A) The pseudowidening
of the JZ. Sagittal (B) and (C) show an
intermediate T2 signal within the endometrial
cavity (orange arrow) with diffuse thickening
of the JZ bulging in the endometrial cavity
(pseudowidening of the JZ, black arrow). Note
the large cystic area on (B, D) consistent with a
subendometrial cyst (white arrow). On (D)
signal hyperintensity is solely seen at the level
of the intermediate T2 signal corresponding
with the endometrial cancer (orange arrow).
No areas of restricted diffusion are seen
within the pseudowidening of the JZ. In this
case, DWI was particularly helpful to delineate
the cancer.
axial obliqueT2-WI
Sagital obliqueT2-
WI
FuseT2-DWI
35. TREATMENT OPTIONS
Medical therapy for adenomyosis relies on hormonal suppression.
Levonorgestrel-releasing IUDs may be slightly more efficacious than oral
contraceptives in reducing pain and uterine bleeding and seem to improve
quality-of-life measures similarly or slightly more than hysterectomy.
Traditionally, the standard treatment of symptomatic adenomyosis has
been hysterectomy
36. Complete adenomyomectomy is effective in the setting of a focal
adenomyoma.
Partial adenomyomectomy, removal of a portion of the clinically
recognizable adenomyosis, is used in the setting of diffuse adenomyosis
when complete resection would effectively result in a functional
hysterectomy.
In select patients, UAE can be used to treat adenomyosis with or without
leiomyomas.
37. SUMMARY
Benign uterine diseases, including adenomyosis and leiomyomas, are
common conditions affecting women of all ages.
US is often the initial imaging study obtained; however, MR imaging
is the preferred modality for additional lesion characterization and
provides critical information to assist in selecting the appropriate
therapies for symptomatic patients.
Treatment options for adenomyosis and leiomyomas include
medical, surgical, and minimally invasive techniques such as UAE.