Mri in ob gy practice

MRI IN OB- GY PRACTICE

Prof. M.C.Bansal.

Founder Principal & Controller;

Jhalawar Medical College And Hospital, Jhalawar.

Ex . Founder Principal & Controller;

Mahatma Gandhi Medical College And Hospital,

Sitapura , jaipur.

MAGNETIC RESONANCE IMAGING( MRI) MRI is one of the great , clinically very

useful modern advances in the field of imaging in medical science.

Radio frequency pulses are directed at living body tissue/ Organ in magnetic field , the tissue emits back(reflected )the modulated radiofrequency signals which are used to construct the image of emitting tissue or organ.

By varying the time of application of radiofrequency pulses and sampling the emitted signals,T1 &T2- weighted images are obtained.

MRI ----- Different tissues appear with different

intensity and brightness in T1 and T2 images.

Depending upon their molecular morphology different tissue emit variable radiofrequency signals—hence different intensity and brightness.

Paramagnetic contrast agents like Gadolinium- DTPA are used for better delineation ( demarcation ) of adjoining tissue / organs.

APPLICATION OF MRI IN GYNAECOLOGY-1 Study of normal uterus and adnexa – with

aim to have clear image of normal myometrium, endometrium , ovary and follicles within the ovary.

Myoma—to differentiate myoma from adenomyoma.localization of myoma—sub serous/ intra mural or sub mucous.

Adenomyosis---accurate diagnosis. Congenital uterovaginal anomalies—

bicornuate, septate,subseptate , unicornuate, didelphys ,rudimentary horn and vaginal atrasia etc

APPLICATION OF MRI IN GYNAECOLOGY --2 Gynaecological cancers--- 1. Cervical cancer –extent of parametrium

and pelvic organs , pelvic L.N., Endocervical. 2.Endometrial cancer –Myometrial

invasion, downward extension to cervix. 3. ovarian cancer—malignant versus

benign mass, ascites , retroperitoneal node > 1cm , Bowel bladder , ano rectal . Parietal peritoneum , liver and or omental metastasis.

4. Pregnancy --- complicated by genital cancers

ADVANTAGES OVER OTHER TYPES OF IMAGING TECHNIQUES MRI is most sensitive for diagnosis of Adenomyosis. MRI Is more accurate and informative in diagnosis

of congenital malformation of genito-urinary tract. Retroparitoneal lymph node > 1cm can be

identified so also such small deposits on bowel / bladder liver can be identified in cases of cancers.

It is more sensitive and accurate tool to assess infiltration of myometrial/ cervical wall, adjoining organs and parametrium --thus helps in pre operative staging of genital carcinomas.

As it is safe in pregnancy –it is useful in diagnosis of obstetrical conditions as well s differentiation of tumors (benign / malignant ) complicating pregnancy.

Uterus

Cervix

Vagina Rectum

Sacrum

Normal- Uterus

A

B

UTERUS ----DIDELPHYS

Ovarian Endometriomaa

Degeneration Of Fibroid

Cystic Degeneration of Fibroid

Endometrial Ca

Endo-ca—extending in

cervical canal

Pelvic Nodes

Ca CX –Extending to

Uterus Bladder

MRI-----Bilateral ovaries with PCOD changes

Ovarian Tumor

Dermoid Cyst

MRI---Pituitary adenoma (A) MRI– Pituitary fosa after surgery of macroadenoma

empty Fosa

MRI Normal Fetal Brain at Term

-MRI—Ft Fetus Wth

Diaphragmatic Hrenia(arrows)