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Comprehensive MR Imaging of Acute Gynecologic Diseases¹

¹ From the Department of Radiology, Kurashiki Central Hospital, Miwa 1-1-1, Kurashiki 710-8602, Japan. Presented as a scientific exhibit at the 1999 RSNA scientific assembly. Received March 2, 2000; revision requested March 29 and received May 22; accepted May 26. Address correspondence to Y.W. (e-mail: yw5904@kchnet.or.jp).

Rapid advances in techniques of magnetic resonance (MR) imaging have enabled diagnosis of acute gynecologic conditions, which are characterized by sudden onset of lower abdominal pain, fever, genital bleeding, intraperitoneal bleeding, or symptoms of shock. The chemical-selective fat-suppression technique not only helps establish the characteristics of lesions that contain fat components but also increases the conspicuity of inflammatory lesions. When a T2-weighted image is obtained with a very long effective echo time (>250 msec), even a small amount of ascites can be easily identified and the contrast between urine and complex fluid becomes more conspicuous. T2*-weighted images are useful for identification of hemorrhagic lesions by demonstrating deoxyhemoglobin and hemosiderin. Contrast material–enhanced dynamic subtraction MR imaging performed with a three-dimensional fast field-echo sequence and a rapid bolus injection of gadopentetate dimeglumine allows evaluation of lesion vascularity and the anatomic relationship between pelvic vessels and a lesion and allows identification of the bleeding point by demonstrating extravasation of contrast material. To optimize the MR imaging examination, attention should be given to the parameters of each pulse sequence and proper combination of the sequences.

Index Terms: Arteriovenous malformations, uterine, 854.494 • Magnetic resonance (MR), technology • Ovary, cysts, 852.31171 • Ovary, neoplasms, 852.313, 852.3192 • Ovary, torsion, 852.899 • Pelvic organs, inflammation, 85.217 • Placenta, abnormalities, 857.3199, 857.8249, 857.8255 • Pregnancy, ectopic, 85.823

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