By Martin C. Powell

Offers the functions of MRI in obstetrics and gynaecology in an in depth, but useful means

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1990) reported 22 out of 24 tumours to have a slightly higher signal intensity to that of normal cervix stroma. Transverse axial Tx -weighted images are helpful in assessing lateral tumour spread into the adjacent pelvic fat, having a comparatively high signal. STIR suppresses the signal from the surrounding tissues and highlights tumour tissue (Fig. 1). This is due to the long Tx and T2 found in most types of tumours (Bydder and Young, 1985). This pulse sequence again is helpful in determining whether there has been tumour invasion into the parametrium.

As with CT, an alteration in the architecture of the lymph node is required before it is involved. Powell et al. (1986e) reported to have missed microscopic tumour deposits in 5 patients who underwent radical surgery. Enlargement of the para-aortic glands can be demonstrated well on a coronal plane of view. 54 Magnetic Resonance Imaging in Obstetrics and Gynaecology (a) (b) (c) (d) Fig. 10 Transverse and sagittal views. Large tumour invading parametrial tissue close to the pelvic side wall. Tumour bulk clearly visible on sagittal view, (a-c) TR 680 ms TE 40 ms; (d) TR 1500 ms TI 100 ms.

The normal rectum has a distinct layer of fat anteriorly and laterally when viewed on both Γ, and TJT2weighted sequences. If posterior invasion by a tumour occurs, then this fat layer with a high Carcinoma of the cervix (a) (b) (c) (d) 53 Fig. 9 Transverse view. Series of high-resolution images demonstrating parametrium (TR 560 ms TE 40 ms). b = Bladder; cx = cervix; ο = obturator internus; ρ = parametrium; r = rectum; s = symphysis pubis; ν = vagina; i = parametrial spread. intensity signal will be breached by the low intensity tumour.

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