الفهرس 
pathologyOnly 14 pages are availabe for public view
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Abstract
A mass in the uterine corpus is a common gynaecological disorder. These masses vary from benign nature masses like fibroids and endometrial polyps to the malignancies as carcinomas and sarcomas. Uterine fibroid is the most common uterine mass. Roughly, it occurs in 20-40% of females in the child bearing period. Endometrial polyps are found in 10% of females, more commonly in the post menopausal status. Endometrial carcinoma is the most common malignancy of the female genital tract. Uterine sarcomas are least common by incidence of 1-3 % of all uterine masses. A pelvic MRI study should include axial T1 weighted SE images, axial and sagittal T2 weighted FSE images, axial and sagittal post contrast T1 FAT SAT SE images. This protocol achieved reliable accuracy, sensitivity and specificity in evaluation of benign masses. For better evaluation of malignant masses, contrast enhanced dynamic T1 images are highly recommended. It allows better evaluation of the extent of myometrial and cervical invasion by the tumor, and so better staging of a malignancy. Also, non contrast T1 weighted images might be obtained with a large field of view which may aid in lymphadenopathy and bone marrow affection. Using lymph node–specific MRI contrast agents, such as ultrasmall superparamagnetic iron oxide (USPIO) particles, improves the sensitivity and specificity of detection of lymph node metastases in patients with endometrial cancer. MRI is a dependable imaging tool for differentiation and diagnosing uterine masses. A uterine fibroid displays low signal intensity relative to the myometrium on T2W imaging and are isointense to myometrium on T1W imaging. On postcontrast imaging, non-degenerated uterine leiomyomas enhance homogeneously. Endometrial polyps appear generally with intermediate signal intensity on T1 weighted images and heterogenous high signal intensity on T2 weighted images. Following intravenous administration of a contrast agent, endometrial polyps show pronounced enhancement, comparable to the surrounding endometrium. Endometrial carcinoma appears iso-intense to the normal endometrium on T1-weighted images, and heterogeneously high signal intensity on T2-weighted sequences. Endometrial cancer enhances earlier than normal endometrium but later than the adjacent myometrium, allowing identification of small tumours, even those contained by the endometrium. Uterine sarcomas has two patterns of appearance in MR imaging. The first is a characteristic large heterogenous pelvic mass and the other is an endometrial mass indistinguishable from endometrial carcinoma. On T2-weighted images, the large masses are of low or intermediate background signal intensity with pockets of very high T2 signal. The areas of high T2 signal corresponded to cystic necrosis in the tumor. Pockets of high T1- weighted signal corresponded to hemorrhage. Gadolinium enhancement is present in the solid components. Magnetic resonance (MR) imaging has proved to be the most valuable diagnostic tool to study the female pelvis.