Adnexa

David Grand, Courtney A. Woodfield, William W. Mayo-Smith
In: Practical Body MRI · 2012 · pp. 83–92 · doi:10.1017/cbo9781139013192.010 · W1488552152
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⚙ AI-generated summary by claude@2026-06, 2026-06-13 ⓘ

This paper describes the standard MRI protocol for evaluating female pelvic conditions such as adnexal and ovarian masses, fibroids, endometriosis, and pelvic pain.

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⚙ AI-generated deep summary by claude@2026-06, 2026-06-13 · read from full text ⓘ

This chapter from Practical Body MRI describes a routine MRI protocol for the female pelvis, including high-level indications, preparation steps (voiding, optional IV contrast with subtraction of pre-/post-contrast images), and the specific sequence set used to evaluate adnexal and uterine pathology. It reports that the protocol is used for detecting and characterizing adnexal/ovarian masses, fibroids, and also for generalized or localized pelvic pain, explicitly listing adenomyosis and endometriosis among the indications. The key emphasis is on image interpretation targets such as diffusion-weighted imaging for lesion detection and multiple T2- and T1-based sequences (including in/out of phase and post-contrast imaging) to define lesion signal characteristics and enhancement patterns. As a protocol/interpretation guide rather than an original study, it does not provide outcome data or comparative performance metrics. This paper is centrally about endometriosis — it explicitly lists endometriosis among the indications for the routine female pelvis MRI protocol and describes sequence-based lesion assessment.

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Abstract

The most commonly used protocol for MRI of the female pelvis. Indications include evaluation of adnexal masses, ovarian masses, fibroids, adenomyosis, endometriosis, and generalized or localized pelvic pain.
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Practical Body MRI Buy print or eBook [Opens in a new window] Protocols, Applications and Image Interpretation - Frontmatter - Contents - Preface - To the reader - Acknowledgments - Glossary of terms andabbreviations used in Body MRI - Section 1 Body MRI overview - Section 2 Abdomen - Section 3 Pelvis - Chapter 7 The female pelvis: uterus - Chapter 8 Adnexa - Chapter 9 Female urethra - Chapter 10 Pelvic floor / prolapse - Chapter 11 Imaging of the pregnant patient - Chapter 12 MRI of male pelvis - Chapter 13 Rectal MRI - Section 4 MRI angiography - Index from Section 3 - Pelvis Published online by Cambridge University Press: 05 November 2012 Book contents - Frontmatter - Contents - Preface - To the reader - Acknowledgments - Glossary of terms andabbreviations used in Body MRI - Section 1 Body MRI overview - Section 2 Abdomen - Section 3 Pelvis - Chapter 7 The female pelvis: uterus - Chapter 8 Adnexa - Chapter 9 Female urethra - Chapter 10 Pelvic floor / prolapse - Chapter 11 Imaging of the pregnant patient - Chapter 12 MRI of male pelvis - Chapter 13 Rectal MRI - Section 4 MRI angiography - Index Routine female pelvis protocol Indications The most commonly used protocol for MRI of the female pelvis. Indications include evaluation of adnexal masses, ovarian masses, fibroids, adenomyosis, endometriosis, and generalized or localized pelvic pain. Preparation IV contrast agent: 1 mmol/kg gadopentetate dimeglumine at 2 cc/s Oral contrast agent: None Have the patient void prior to the start of the study. Start IV with at least 24-gauge needle; connect to power injector Subtract pre-contrast images from post-contrast images Cover from iliac crests through symphysis pubis. If pathology extends above or below these levels, increase coverage. Exam sequences and what we are looking for (1) Diffusion-weighted imaging b50, 500/ADC – Excellent for lesion detection. (2) Coronal T2 single-shot fast-spin echo BH (large field of view to cover at least ½ kidneys) – Assess presence and location of kidneys. Evaluate for hydronephrosis. (3) Sagittal T2 fast-spin echo – Evaluate uterine anatomy. Identify T2-bright and T2-dark lesions. (4) Axial T2 fast-spin echo – Identify T2-bright and T2-dark lesions. (5) Coronal T2 fast-spin echo FS – Identify T2-bright and T2-dark lesions. Evaluate for pelvic fluid and T2-bright osseous lesions. (6–7) Axial T1 in and out of phase (IP/OOP) – Identify T1-bright lesions and microscopic fat. (8) Axial volume-interpolated gradient echo BH pre – Characterize T1-bright signal in lesions. (9) Axial volume-interpolated gradient echo BH post 70 seconds. Determine enhancement. (10) Sagittal volume-interpolated gradient echo BH post to follow. - Type - Chapter - Information - Practical Body MRIProtocols, Applications and Image Interpretation, pp. 83 - 92Publisher: Cambridge University PressPrint publication year: 2012 Accessibility compliance for the PDF of this chapter is currently unknown and may be updated in the future. To save this book to your Kindle, first ensure [email protected] is added to your Approved Personal Document E-mail List under your Personal Document Settings on the Manage Your Content and Devices page of your Amazon account. Then enter the ‘name’ part of your Kindle email address below. Find out more about saving to your Kindle. Note you can select to save to either the @free.kindle.com or @kindle.com variations. ‘@free.kindle.com’ emails are free but can only be saved to your device when it is connected to wi-fi. ‘@kindle.com’ emails can be delivered even when you are not connected to wi-fi, but note that service fees apply. Find out more about the Kindle Personal Document Service. - Adnexa - Book: Practical Body MRI - Online publication: 05 November 2012 To save content items to your account, please confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account. Find out more about saving content to Dropbox. - Adnexa - Book: Practical Body MRI - Online publication: 05 November 2012 To save content items to your account, please confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account. Find out more about saving content to Google Drive. - Adnexa - Book: Practical Body MRI - Online publication: 05 November 2012

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