Magnetic Resonance Imaging of Uterine Cervix: A Pictorial Essay

Abstract

Uterine cervix is the lower constricted part of uterus which is best evaluated by magnetic resonance imaging (MRI) due to its higher soft tissue and contrast resolution. The cervical cancer is a common gynecological cancer causing much morbidity and mortality especially in developing countries. Cervical carcinomas mainly occurs in reproductive age group with prognosis mainly depending on the extent of disease at the time of diagnosis, hence it is important to identify these cancerous lesions early and stage them accurately for optimal treatment. In this article, we will review the following: (1) the normal MRI anatomy of uterine cervix; (2) MRI protocol and techniques in evaluation of cervical lesions; (3) imaging of spectrum of various congenital abnormalities and pathologies affecting uterine cervix which ranges from congenital abnormalities to various benign lesions of cervix like nabothian cysts, tunnel cysts, cervicitis, cervical fibroid, and, lastly, endometriosis which usually coexists with adenomyosis; the malignant lesions include carcinoma cervix, adenoma malignum or direct extension from carcinoma endometrium or from carcinoma of vagina; (4) Accurately stage carcinoma of cervix using FIGO classification (2018); and (5) posttreatment evaluation of cervical cancers. MRI is the most reliable imaging modality in evaluation of various cervical lesions, identification of cervical tumors, staging of the cervical malignancy, and stratifying patients for surgery and radiation therapy. It also plays an important role in detection of local disease recurrence.

Diffusion-weighted imaging in the assessment of cervical cancer: comparison of reduced field-of-view diffusion-weighted imaging and conventional techniques

“…Magnetic resonance imaging (MRI) is highly sensitive to changes in soft tissues and is extensively used in the screening and diagnostic process of cervical cancer (9,10). Diffusion-weighted imaging (DWI) can display the diffusion movement of water molecules in living tissues to distinguish normal tissues from malignant cells and aid in clinical diagnosis (9,11). It has been widely employed because of this benefit, and the clinical application impact is positive (9,11).…”

“…Diffusion-weighted imaging (DWI) can display the diffusion movement of water molecules in living tissues to distinguish normal tissues from malignant cells and aid in clinical diagnosis (9,11). It has been widely employed because of this benefit, and the clinical application impact is positive (9,11). The apparent diffusion coefficient (ADC) obtained from DW images was also successfully introduced into the quantitative characteristics of cervical cancer (9,10).…”

Large Cervical Leiomyoma of the Uterus: A Rare Cause of Chronic Pelvic Pain Associated With Obstructive Uropathy and Renal Dysfunction: A Case Report

“…Magnetic resonance imaging (MRI), due to the higher resolution of soft tissues that characterizes it, is currently the best method for imaging the normal anatomy of the cervix and evaluating cervical lesions. Magnetic resonance imaging is estimated to be of significant help in the challenging differential diagnosis of cervical fibroids from adnexal tumors [ 16 ]. On MRI, cervical leiomyomas appear as a well-defined, rounded, T2 hypo-isointense lesion showing homogeneous enhancement centered on the cervix.…”

Arbor Vitae Uteri

“…We read with interest the pictorial essay, “Magnetic Resonance Imaging of Uterine Cervix: A Pictorial Essay,” by Gala et al 1 The article is an excellent depiction of various pathologies affecting uterine cervix. However, we would like to make the following contributions.…”