MRI Findings of Cavernous Hemangioma of the Uterus: A Case Report

Hemangioma is the most common soft tissue tumor in the body. Though it may occur anywhere in the body, hemangioma of the uterus is a very rare tumor. Hemangioma is almost asymptomatic, but it is sometimes clinically important because it can cause massive hemorrhage and this is a life-threatening condition. We report here on the magnetic resonance imaging and pathologic findings of cavernous hemangioma of the uterus in a 32-year-woman with menorrhagia.

Two Cases of Primary Uterine Leiomyosarcoma:MR Findings and Pathologic Correlation

Primary uterine leiomyosarcomas are very rare malignant tumors and the related MR findings have been the subject of only a few case reports. We describe the MR findings of two cases of histologically confirmed primary leiomyosarcoma, correlating these pathologic findings.

Cervical Carcinoma vs Endometrial Carcinoma, Involving Both Corpus and Cervix: Comparison of Growing Pattern with MR Imaging

PURPOSE: To evaluate the growth pattern depicted by MR imaging and used to differentiate between uterine cervcal and endometrial carcinoma where the mass involves both the uterine corpus and cervix. MATERIALS AND METHODS: The tumor growth pattern observed on MR images obtained between November 1989 and January in 1999 in 37 of 784 cervical carcinomas and 9 of 47 endometrial carcinomas in which the tumor involved both the uterine corpus and cervix was analysed. The histologic type was squamous (n=29), adenocarcinomatous (n=6) or adenosquamous (n=2) in cervical carcinoma, and carcinomatous (n=8) or adenosquamous (n=1) in endometrial carcinoma. A 1.5-T (Magnetom Vision, Siemens, Germany) and a 2.0-T unit (Spectro-20000, Goldstar, Korea) were used to obtain T1-and T2-weighted axial, T2-weighted sagittal and Gdenhanced images. Tumor involvement of the uterine cervix was classified as either partial(Cp) or total(Ct), and partial involvement(Cp) was subclassified as Cp-n, Cp-x, or Cp-b according to involvement of the endocervix, exocervix or both. Tumors of the uterine corpus were classified as involving the mucosa(U-mu), myometrium(U-my) or serosa(U-se). RESULTS: In 37 cases of cervical carcinoma, all three involving the endocervix(Cp-n) invaded the endometrium(U-mu), three involving both the endo- and exocervix(Cp-b) invaded the endometrium(U-mu, 1 case), myometrium(U-my, 1 case), or serosa(U-se, 1 case), and 31 involving the full-thickness of the uterine cervix(Ct) invaded the endometrium (U-mu, 6 cases) or serosa(U-se, 25 cases). In nine cases of endometrial carcinoma, three involving the endometrium(U-mu) and five involving the myometrium(U-my) invaded the endocervix(Cp-n), and one involving the serosa(U-se) invaded the full-thickness of the uterine cervix(Ct). CONCLUSION: Cervical carcinoma tended to involve the entire cervix and the full thickness of the uterine corpus, but endometrial carcinoma tended to involve the endometrium or myometrium of the uterine corpus and endocervix.

CT and MR Imaging Findings of Cystic Adenomyosis of the Uterus: Report of Three Cases

Adenomyosis of the uterus is a relatively common gynecologic disease characterized by the presence of ectopic endometrial glands and stroma within the myometrium. Small cystic spaces (not larger than several mil-limeters) are invariably present, and these are filled with blood. Extensive hemorrhagic cystic adenomyosis,however, is rare, and there have been very few radiologic reports of this condition. We describe the CT and MRI features of three cases of histologically confirmed huge cystic adenomyosis.

Differential Diagnosis of Bicornuate and Septate Uterus : Is Comparison of Septal Signal Intensity on MR Image Useful?

PURPOSE: To evaluate the usefulness of comparison of the signal intensity of uterine septum in the differential diagnosis of bicornuate and septate uterus on magnetic resonance (MR) imaging. MATERIALS AND METHODS: Preoperative MR imaging findings of surgically proven 5 bicornuate and 6 septate uteri were retrospectively analyzed. Because preoperative differential diagnosis of both was possible in all cases in terms of the intercornual distance, external contour of uterine fundus, and divergent angle of two uterine cavities, these criteria were excluded in this study. The signal intensity of uterine septum in patients with bicornuate and septate uterus was analyzed on T1-weighted and fast spin echo T2-weighted images obtained in the axial and coronal planes, using a 1.5-T MR scanner. The signal intensity of uterine septum especially on T2-weighted images was compared with that of myometrium or junctional zone. RESULTS: The signal intensity of uterine septum in patients with bicornuate uterus (n=5) and septate uterus (n=6) was similar to that of myometrium in all cases on T1-weighted images. The septum of bicornuate uterus (n=5) on fast spin echo T2-weighted images was isointense with myometrium in three and hypointense in two cases. The uterine septum of septate uterus (n=6) on T2-weighted images was isointense with myometrium in two, hypointense in two, and isointense with or more hypointense than junctional zone in two cases. No patient showed different signal intensity between upper and lower uterine septum. CONCLUSION: Because the MR signal intensity of the uterine septum in bicornuate or septate uterus is variable, it should not be used alone in the differential diagnosis of them. In these clinically important differentiation, therefore, comprehensive analysis of MR findings in terms of the external contour of uterine fundus, intercornual distance, divergent angle of two uterine cavities, in addition to the signal intensity of the uterine septum, should be considered.

MR Imaging of Asherman's Syndrome in Patients With and Without Uterine Anomalies: Comparison withHysterosalpingography

PURPOSE: To assess the role of MR imaging in the detection of Asherman's syndrome, especially whenthis is associated with a congenital uterine anomaly. MATERIALS AND METHODS: MR images were obtained in thesemicoronal plane parallel to the long axis of the uterus in 11 patients. Dilatation and curettage involving thein-sertion of an intrauterine device was performed in all patients, and transabdominal metroplasty was performedin four with uterine anomaly. MR imaging findings we r e compared with those of hyste rosalpingograhy in all patients and compared with sur-gical findings in four. RESULTS: The MR findings of uterine synechiademonstrated in nine of 11 patients were focal thickening of the uterine junctional zone (n=2), hypointense fociin the en-dometrium (n=1), or both these findings (n=6). Seven of the 11 patients had associat-ed uterineanomalies, which were demonstrated in all seven by MR imaging. In four of the seven, HSG failed to demonstratethese anomalies. CONCLUSION: MR imaging satisfactorily demonstrated intrauterine lesions in nine of 11 patientswith Asherman's syndrome, and was especially helpful in demonstrating associated uterine anomalies.

MR Imaging of Focal Cervical Edema Mimicking Carcinoma: A Case Report

We describe the MR findings in a patient with stage-I carcinoma confined to the posterior lip of the uterinecervix, a "mass-like", separate, localized area of edema developed in the anterior lip. preoperative MR imagingcould not distinguish edema from tumor, through MR imaging of the surgical specimen edema from tumor on accountof the higher signal intensity of the former. Histopathologic correlation is illustrated.

Uterine Didelphys with Blind Hemivagina, Hematocolpos, Ipsilateral Renal Agenesis (UD-BHRA) and BilateralOvarian Tumors: A Case Report

Uterine didelphys is a congenital malformation characterized by the presence of two separated hemiuteri andhemivaginas, due to lack of midfusion of the Mullerian ducts. We report a case of UD-BHRA(uterine didelphys withblind hemivagina and ipsilateral renal agenesis), a rare type of uterine didelphys charaterized by symptomaticunilateral hematocolpos due to blind hemivagina after menarche and ipsilateral renal agenesis. The MRI findings in22-year-old woman with bilateral ovarian tumors demonstrated two separated uterine horns and cervical and vaginalcanals, with left hematocolpos and left renal agenesis.