Jalal Jalal Shokouhi-MD Ali Akbar Ameri- MD Shahyar Pashaei-PhD, anatomist +989121137884.

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Presentation transcript:

Jalal Jalal Shokouhi-MD Ali Akbar Ameri- MD Shahyar Pashaei-PhD, anatomist

Endometerium: 1. US is first choice 2. MRI: diagnosis and staging of malignancies * MR-features do not diagnose endometrial polyps from cancer!?

1- Benign lesions Congenital UT disorders, leiomyomas, polyp, hyperplasia, adenomyosis, endometeriosis,cystic teratomas

Endometrial atrophy

UTERINE PERISTALSIS

DIDELPHYS

BICORNUATE

Mimics of Bicornute Uterus

SEPTATE

COMPLEX ANOMALIES

2-Malignants: endometrial cancer (early, late, recurrence), sarcoma, adenosarcoma, mixed mesodermal, neoplasms, liomyosarcoma, lymphoma, choriocarcinoma, metastasis

ENDOMETRIAL CANCER, EARLY STAGE

ENDOMETRIAL THICKENING

ENDOMETRIAL POLYP ADENOMYOSIS

ENDOMETRIAL CANCER, LATE STAGE

ENDOMETRIAL CANCER, RECURRENCE

DDx: Endometrial Carcinoma Recurrence Post-surgical granuloma

ENDOMETRIAL CANCER, RECURRENCE

ENDOMETRIAL STROMAL SARCOMA

ADENOSARCOMA

Uterine masses Endometrial polyp Endometrial cancer

MALIGNANT MIXED MESODERMAL TUMOR

LYMPHOMA, UTERUS

Choriocarcinoma,uterus

DDx: Choriocarcinoma Molar pregnancy Retained products of conception

Metastases, uterus

3-Others: adenomyosis, asherman, cystic adenomyosis, tomoxifen, induced changes, IUCD, age and hormonal changes

ADENOMYOSIS

Cystic adenomyosis

Hemorrhagic leiomyoma Gartner duct cyst

INTRAUTERINE DEVICE EVALUATION

TAMOXIFEN-INDUCED CHANGES

Endometerium: 1. Proliferatine 3-8 mm 2. Secretary 5-16 mm 3. Menopause a. No bleeding = 8 mm b. With bleeding = 5 mm 4. Atrophic > 4 mm

MRI of endometrium: T1 intermediate signal T2 high signal STIR, MR-myelogram high signal * UT peristalsis signal ↓, thickness change

Conclusion: *MR-features do not accurately distinguish endometrial polyps from cancer because images limited to T2 signal and T1 anatomy *For congenital anomalies % accuracy *Can be use for diethylbestrol exposure (hyperplasia, T-shaped, UT, endometrial constriction, hydrosalpinges and short cervix)