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OB/Gyn

Axial T2 weighted image of the pelvis at the level of the pubic symphysis demonstrates a small left-ward projecting urethral diverticulum. Sagittal MR image obtained of a supine patient performing the Valsalva maneuver. The descent of the urinary bladder, vagina, and rectum are compared to the pubococcygeal line.Subtracted maximum intensity projection coronal post contrast MR image showing retrograde flow in a dilated left ovarian vein, with left parametrial varices.Axial and sagittal T2 weighted and post contrast images demonstrating a polypoid endometrial mass with myometrial invasion, confirmed as endometrial cancer on biopsy.MRI of cystic lesion seen on ultrasound in a patient with history of multiple bowel surgeries. Images show right ovary surrounded by fluid, characteristic of a peritoneal inclusion cyst.Ovarian carcinoma with cystic foci and mural nodules.This is confirmed on multiple views.MRI of an adnexal lesion seen on ultrasound (circle). The lesion definitely contains fat as evidenced by india inking (dashed arrow) and also has fluid-fluid levels (arrow). This permits confident diagnosis as a dermoid.Unusual pattern of metastasis that is clearly within the liver, as opposed to the usual pattern of capsular implants.Sagittal post contrast fat saturated image of the pelvis.Sagittal T2 weighted image of the pelvis.Sagittal T2 weighted image demonstrates a uterus enlarged by multiple predominantly intramural, circumscribed, T2 hypointense massses, compatible with fibroids.Large intramural fibroid.Same intramural fibroid but also an adjacent pedunculated fibroidSame pedunculated fibroid. Contrast agent helps show the stalk.Bilateral ovarian endometriomas and right hematosalpinx with bright T1 signal, indicative of hemorrhage.Focal adenomyosis as seen by thickening of the junctional zone, along with punctate high signal foci (dashed arrows). Incidental note is made of Nabothian cysts (arrows).Note left ovarian endometrioma (arrow), with a characteristic fluid/fluid level (dashed arrow).Another example of endometriosis, this time with deep endometriosis involving the bowel. Note tethering of bowel (thin arrrow) with bowel wall thickening behind uterus (thick arrow). For comparison note normal thickness of the posterior margin of the bowel (arrowhead).PET-MR. PET-MRI can accurately stage gynecological malignancies, assessing both local and distant disease.PET-MR. This hybrid exam couples high resolution and flexible contrast of MRI with metabolic imaging of PET. Gynecological malignancies may be well assessed.