Benign Diseases of the Female Genital Tract

  • Caroline Reinhold
  • Rahel A. Kubik-Huch


Endovaginal sonography (EVS) remains the procedure of choice for the initial evaluation of benign diseases of the female genital tract. When EVS findings are indeterminate, further evaluation is typically performed with magnetic resonance imaging (MRI), due to its excellent softtissue differentiation, multiplanar capabilities, and absence of ionizing radiation. MRI is thus well suited for imaging women of reproductive age, particularly during pregnancy. Accordingly, the technique has come to play an increasing role in pelvimetry and, more recently, as an adjunct to sonography for fetal imaging. MRI is used in the pre-operative characterization of adnexal masses and as a problem-solving tool in benign uterine disease (for example, uterine malformations), adenomyosis, and to select appropriate candidates for therapies such as myo — mectomy and uterine embolization. The role of computed tomography (CT) is limited in the evaluation of benign disease of the female pelvis and is usually employed in an emergency situation, such as in an acute abdomen caused by ovarian torsion or pelvic inflammatory disease.


Pelvic Inflammatory Disease Adnexal Mass Endometrial Polyp Mature Cystic Teratoma Intermediate Signal Intensity 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.


Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.


  1. 1.
    Cohen HL, Tice HM, Mandel FS (1990) Ovarian volumes measured by US: bigger than we think. Radiology 177:189–192PubMedGoogle Scholar
  2. 2.
    Goswamy RK, Campbell S, Royston JP et al (1988) Ovarian size in postmenopausal women. Br J Obstet Gynaecol 95:795–801CrossRefPubMedGoogle Scholar
  3. 3.
    Levine D, Gosink BB, Wolf SI et al (1992) Simple adnexal cysts: the natural history in postmenopausal women. Radiology 184:653–659PubMedGoogle Scholar
  4. 4.
    Outwater EK, Talerman A, Duncon C (1996) Normal adnex a uteri specimens: anatomic basis of MR imaging features. Radiology 201:751–755PubMedGoogle Scholar
  5. 5.
    Outwater EK, Mitchell DG (1996) Normal ovaries and functional cysts: MR appearance. Radiology 198:397–402PubMedGoogle Scholar
  6. 6.
    Buttram VC, Gibbons, WE (1979) Mullerian anomalies: a proposed classification (an analysis of 144 cases). Fertil Steril 32:40–46PubMedGoogle Scholar
  7. 7.
    The American Fertility Society (1988) The American Fertility Society classifications of adnexal adhesions, distal tubal obstruction, tubal occlusion secondary to tubal ligation, tubal pregnancies, mullerian anomalies and intrauterine adhesions. Fertil Steril 49:944–955Google Scholar
  8. 8.
    Trojano RN (2003) Magnetic resonance imaging of mullerian duct anomalies of the uterus. Top Magn Reson Imaging 14: 269–279CrossRefGoogle Scholar
  9. 9.
    Carrington BM, Hricak H, Nuruddin RN et al (1990) Mullerian duct anomalies: MR imaging evaluation. Radiology 176:715–720PubMedGoogle Scholar
  10. 10.
    Pellerito JS, McCarthy SM, Doyle MB et al (1992) Diagnosis of uterine anomalies: relative accuracy of MR imaging, endovaginal ultrasound, and hysterosalpingography. Radiology 183:795–800PubMedGoogle Scholar
  11. 11.
    Junqueira BLP, Allen LM, Spitzer RF et al (2009) Mullerian duct anomalies and mimics in children and adolescents: Correlative intraoperative assessment with clinical imaging. Radiographics 29:1085–1103CrossRefPubMedGoogle Scholar
  12. 12.
    Homer HA, Li TC, Cooke ID (2000) The septate uterus: a review of management and reproductive outcome. Fertil Steril 73:1–14CrossRefPubMedGoogle Scholar
  13. 13.
    Sheth S, Hamper UM, Kurman RJ (1993) Thickened endometrium in the postmenopausal woman: sonographic-pathologic correlation. Radiology 187:135–139PubMedGoogle Scholar
  14. 14.
    Pertl B, Lahousen M, Pieber D et al (1996) Stellenwert der Sonograhie bei der Früherkennung des Endometriumkarzinoms. Gynäkologisch-geburtshilfliche Rundschau 36:14–20CrossRefPubMedGoogle Scholar
  15. 15.
    Grasel RP, Outwater EK, Siegelman ES et al (2000) Endometrial polyps: MR imaging features and distinction from endometrial carcinoma. Radiology 214:47–52PubMedGoogle Scholar
  16. 16.
    Hricak H, Tscholakoff D, Heinrichs L et al (1986) Uterine leiomyomas: correlation of MR histopathologic findings, and symptoms. Radiology 158:385–391PubMedGoogle Scholar
  17. 17.
    Reinhold C, McCarthy S, Bret PM et al (1996) Diffuse adenomyosis: Comparison of endovaginal US and MR imaging with histopathologic correlation. Radiology 199:151–158PubMedGoogle Scholar
  18. 18.
    Togashi K, Ozasa H, Konishi I et al (1989) Enlarged uterus: Differentiation between adenomyosis and leiomyoma with MR imaging. Radiology 171:531–534PubMedGoogle Scholar
  19. 19.
    Mark AS, Hricak H, Heinrichs LW et al (1987) Adenomyosis and leiomyoma: Differential diagnosis with MR imaging. Radiology 163:527–529PubMedGoogle Scholar
  20. 20.
    Kurman RJ (1987) Blaustein’s pathology of the female genital tract. 3rd edn. Springer-Verlag, New YorkGoogle Scholar
  21. 21.
    Levy AD, Arnaiz J, Shaw JC, Sobin LH (2008) From the archives of the AFIP: Primary peritoneal tumors: Imaging features with pathologic correlation. Radiographics 28:583–607CrossRefPubMedGoogle Scholar
  22. 22.
    Togashi K, Nishimura K, Kimura I et al (1991) Endometrial cysts: diagnosis with MR imaging. Radiology 180:73–78PubMedGoogle Scholar
  23. 23.
    Hottat N, Larrousse C, Anaf V et al (2009) Endometriosis: Contribution of 3.0-T pelvic MR imaging in preoperative assessment — initial results. Radiology 253:126–134CrossRefPubMedGoogle Scholar
  24. 24.
    Thomassin-Naggara I, Bazot M, Darai E et al (2008) Epithelial ovarian tumors: Value of dynamic contrast-enhanced MR imaging and correlation with tumor angiogenesis. Radiology 248:148–159CrossRefPubMedGoogle Scholar
  25. 25.
    Togashi K (2003) MR imaging of the ovaries: normal appearance and benign disease. Radiol Clin N Am 41:799–811CrossRefPubMedGoogle Scholar
  26. 26.
    Malde HM, Kedar RP, Chadha D et al (1992) Dermoid mesh: a sonographic sign of ovarian teratoma. Letter Am J Roentgenol 159:1349–1350Google Scholar
  27. 27.
    Outwater EK, Siegelman ES, Hunt JL (2001) Ovarian teratomas: tumor types and imaging characteristics. Radiographics 21:475–490PubMedGoogle Scholar
  28. 28.
    Troiano RN, Lazzarini KM, Scoutt LM et al (1997) Fibroma and fibrothecoma of the ovary: MR imaging findings. Radiology 204:795–798PubMedGoogle Scholar
  29. 29.
    Michel SC, Rake A, Treiber K et al (2002) MR obstetric pelvimetry: effect of birthing position on pelvic bony dimensions. AJR Am J Roentgenol 79:1063–1067 (Abstract and editorial comment in Obstetrical & Gynecological Survey 2003; 54:238–239)Google Scholar
  30. 30.
    Keller TM, Rake A, Michel SCA et al (2003) Obstetric MR pelvimetry: Reference values and evaluation of inter-and intraobserver error and intraindividual variability. Radiology 227:37–43CrossRefPubMedGoogle Scholar
  31. 31.
    Keller TM, Rake A, Michel SCA et al (2004) MR assessment of fetal lung development using lung volumes and signal intensities. Eur Radiol 14:984–989CrossRefPubMedGoogle Scholar
  32. 32.
    Huisman TA, Wisser J, Martin E et al (2002) Fetal magnetic resonance imaging of the central nervous system. Eur Radiol 12:1952–1961PubMedGoogle Scholar

Copyright information

© Springer Verlag Italia 2010

Authors and Affiliations

  • Caroline Reinhold
    • 1
  • Rahel A. Kubik-Huch
    • 2
  1. 1.McGill University Health CenterMontrealCanada
  2. 2.Institute of Radiology, Department of Medical ServicesKantonsspital BadenBadenSwitzerland

Personalised recommendations