Magnetic resonance imaging for gynaecological masses

A mass in the pelvis is a frequent gynaecological problem. Clinical presentation is usually late or fortuitous. More widespread use of imaging is identifying many masses in the pelvis at an earlier stage than previously. Imaging techniques can be used to identify masses, to evaluate their nature and to help in the planning of treatment. Because of logistic problems and the widespread availability of ultrasound, magnetic resonance plays little part in the identification of pelvic masses. It is, however, of considerable value in the evaluation of disease in the uterus and ovaries. Experience in interpreting MR appearances of the various types of ovarian and uterine tumours is growing, frequently allowing preoperative differentiation between benign and malignant pathologies. Spread of tumour is evaluable, particularly cervical tumours into the parametrium and upper vagina and endometrial cancer into the myometrium and cervix. MR currently has an important role in planning management of gynaecological tumours, but in the future it is likely that this will be overtaken by positron emission tomography (PET) in the form of PET/CT or PET/MRI.