Diagnostic Imaging: Gynecology

Part I: Techniques
SECTION 1: PELVIS

4 Ultrasound Technique and Anatomy
Douglas Rogers, MD and Marc S. Tubay, MD

10 Hysterosalpingography
Douglas Rogers, MD and Marc S. Tubay, MD

16 Sonohysterography
Akram M. Shaaban, MBBCh and Douglas Rogers, MD

20 CT Technique and Anatomy
Marc S. Tubay, MD

24 MR Technique and Anatomy
Marc S. Tubay, MD

30 PET/CT Technique and Imaging Issues
Marc S. Tubay, MD

Part II: Uterus
SECTION 1: INTRODUCTION AND OVERVIEW

38 Anatomy of the Uterus
Paula J. Woodward, MD and Akram M. Shaaban, MBBCh

SECTION 2: AGE-RELATED CHANGES

60 Endometrial Atrophy
Maryam Rezvani, MD, Jeffrey Olpin, MD, and Sandra J.
Allison, MD

SECTION 3: CONGENITAL

64 Introduction to Müllerian Duct Anomalies
Akram M. Shaaban, MBBCh

68 Müllerian Agenesis
Akram M. Shaaban, MBBCh, Nyree Griffin, MD, FRCR, and
Caroline Reinhold, MD, MSc

74 Unicornuate Uterus
Akram M. Shaaban, MBBCh, Nyree Griffin, MD, FRCR, and
Caroline Reinhold, MD, MSc

80 Uterus Didelphys
Akram M. Shaaban, MBBCh, Nyree Griffin, MD, FRCR, and
Caroline Reinhold, MD, MSc

86 Bicornuate Uterus
Akram M. Shaaban, MBBCh, Caroline Reinhold, MD, MSc,
and Khashayar Rafatzand, MD, FRCPC

90 Septate Uterus
Akram M. Shaaban, MBBCh and Susan M. Ascher, MD,
FISMRM, FSCBT/MR

96 Arcuate Uterus
Akram M. Shaaban, MBBCh, Nyree Griffin, MD, FRCR, and
Evis Sala, MD, PhD

98 DES Exposure
Akram M. Shaaban, MBBCh, Nyree Griffin, MD, FRCR, and
Evis Sala, MD, PhD

SECTION 4: INFLAMMATION/INFECTION

102 Asherman Syndrome, Endometrial Synechiae
Douglas Rogers, MD and Christine O. Menias, MD

106 Endometritis
Douglas Rogers, MD and Christine O. Menias, MD

110 Pyomyoma
Douglas Rogers, MD

SECTION 5: BENIGN NEOPLASMS
MYOMETRIUM

116 Uterine Leiomyoma
Maryam Rezvani, MD and Jeffrey Olpin, MD

122 Leiomyomas: Degeneration, Variants, and
Complications
Marc S. Tubay, MD and Jeffrey Olpin, MD

130 Benign Metastasizing Leiomyoma
Akram M. Shaaban, MBBCh and Winnie Hahn, MD

132 Diffuse Leiomyomatosis
Douglas Rogers, MD and Christine O. Menias, MD

134 Intravenous Leiomyomatosis
Douglas Rogers, MD

138 Disseminated Peritoneal Leiomyomatosis
Douglas Rogers, MD and Christine O. Menias, MD

142 Lipomatous Uterine Tumors
Douglas Rogers, MD and Christine O. Menias, MD
ENDOMETRIUM

146 Endometrial Polyps
Maryam Rezvani, MD and Jeffrey Olpin, MD

152 Endometrial Hyperplasia
Maryam Rezvani, MD and Jeffrey Olpin, MD

SECTION 6: MALIGNANT NEOPLASMS ENDOMETRIUM

158 Corpus Uteri Carcinoma
Maryam Rezvani, MD

174 Uterine Adenosarcoma
Douglas Rogers, MD

178 Endometrial Stromal Sarcoma
Douglas Rogers, MD

182 Uterine Carcinosarcoma
Douglas Rogers, MD

186 Gestational Trophoblastic Neoplasms
Akram M. Shaaban, MBBCh
MYOMETRIUM

196 Uterine Leiomyosarcoma
Douglas Rogers, MD

SECTION 7: VASCULAR

202 Uterine Arteriovenous Malformation
Maryam Rezvani, MD and Jeffrey Olpin, MD

208 Uterine Artery Embolization Imaging
Jeffrey Olpin, MD and Maryam Rezvani, MD
SECTION 8: TREATMENT-RELATED
CONDITIONS

216 Tamoxifen-Induced Changes
Jeffrey Olpin, MD and Maryam Rezvani, MD

222 Contraceptive Device Evaluation
Maryam Rezvani, MD and Jeffrey Olpin, MD

230 Post Cesarean Section Appearance
Maryam Rezvani, MD and Jeffrey Olpin, MD
SECTION 9: ADENOMYOSIS

236 Adenomyosis
Jeffrey Olpin, MD and Maryam Rezvani, MD

242 Adenomyoma
Maryam Rezvani, MD and Jeffrey Olpin, MD

246 Cystic Adenomyosis
Maryam Rezvani, MD and Jeffrey Olpin, MD

Part III: Cervix
SECTION 1: INTRODUCTION AND OVERVIEW

252 Anatomy of the Cervix
Marc S. Tubay, MD

SECTION 2: INFECTION/INFLAMMATION

260 Cervical Stenosis
Douglas Rogers, MD

SECTION 3: BENIGN NEOPLASMS

266 Endocervical Polyp
Douglas Rogers, MD

270 Cervical Leiomyoma
Douglas Rogers, MD

SECTION 4: MALIGNANT NEOPLASMS

276 Corpus Uteri Sarcoma
Maryam Rezvani, MD

288 Cervix Uteri Carcinoma
Maryam Rezvani, MD

308 Adenoma Malignum
Douglas Rogers, MD

312 Cervical Sarcoma
Douglas Rogers, MD

316 Cervical Melanoma
Akram M. Shaaban, MBBCh, Nyree Griffin, MD, FRCR, and
Evis Sala, MD, PhD

SECTION 5: TREATMENT-RELATED CONDITIONS

322 Posttrachelectomy Appearances
Maryam Rezvani, MD and Jeffrey Olpin, MD

SECTION 6: MISCELLANEOUS

326 Cervical Glandular Hyperplasia
Maryam Rezvani, MD and Jeffrey Olpin, MD

330 Nabothian Cysts
Maryam Rezvani, MD and Jeffrey Olpin, MD

Part IV: Vagina and Vulva
SECTION 1: INTRODUCTION AND OVERVIEW

336 Vaginal and Vulvar Anatomy
Marc S. Tubay, MD

SECTION 2: CONGENITAL

346 Lower Vaginal Atresia
Douglas Rogers, MD

348 Imperforate Hymen
Douglas Rogers, MD

350 Vaginal Septa
Douglas Rogers, MD

SECTION 3: BENIGN NEOPLASMS

354 Vaginal Leiomyoma
Akram M. Shaaban, MBBCh, Olga Hatsiopoulou, MD,
FRCR, and Evis Sala, MD, PhD

360 Vulvar Slow-Flow Vascular Malformation
Douglas Rogers, MD

364 Vaginal Paraganglioma
Douglas Rogers, MD

SECTION 4: MALIGNANT NEOPLASMS

370 Vaginal Carcinoma
Akram M. Shaaban, MBBCh

382 Vaginal Leiomyosarcoma
Akram M. Shaaban, MBBCh, Olga Hatsiopoulou, MD,
FRCR, and Evis Sala, MD, PhD

384 Embryonal Rhabdomyosarcoma
Douglas Rogers, MD

388 Vaginal Yolk Sac Tumor
Akram M. Shaaban, MBBCh, Olga Hatsiopoulou, MD,
FRCR, and Evis Sala, MD, PhD

392 Bartholin Gland Carcinoma
Douglas Rogers, MD

396 Vulvar Carcinoma
Maryam Rezvani, MD

408 Vulvar Leiomyosarcoma
Douglas Rogers, MD

410 Vulvar and Vaginal Melanoma
Akram M. Shaaban, MBBCh and Evis Sala, MD, PhD

416 Aggressive Angiomyxoma
Douglas Rogers, MD

420 Merkel Cell Tumor
Douglas Rogers, MD

SECTION 5: LOWER GENITAL CYSTS

424 Gartner Duct Cysts
Marc S. Tubay, MD and Akram M. Shaaban, MBBCh

428 Bartholin Cysts
Marc S. Tubay, MD and Akram M. Shaaban, MBBCh

434 Urethral Diverticulum
Marc S. Tubay, MD and Akram M. Shaaban, MBBCh

438 Skene Gland Cyst
Marc S. Tubay, MD and Akram M. Shaaban, MBBCh
SECTION 6: MISCELLANEOUS

444 Vaginal Foreign Bodies
Douglas Rogers, MD

452 Vaginal Fistula
Marc S. Tubay, MD and Akram M. Shaaban, MBBCh

Part V: Ovary
SECTION 1: INTRODUCTION AND OVERVIEW

460 Anatomy of the Ovaries
Paula J. Woodward, MD and Akram M. Shaaban, MBBCh

SECTION 2: PHYSIOLOGIC AND AGERELATED CHANGES

470 Follicular Cyst
Marc S. Tubay, MD

474 Corpus Luteum
Marc S. Tubay, MD and Akram M. Shaaban, MBBCh

480 Theca Lutein Cysts
Akram M. Shaaban, MBBCh, Patricia Noël, MD, FRCPC,
and Caroline Reinhold, MD, MSc

484 Hemorrhagic Ovarian Cyst
Paula J. Woodward, MD

490 Ovarian Inclusion Cyst
Marc S. Tubay, MD

SECTION 3: NEOPLASMS

498 Overview of Ovary, Fallopian Tube, and Primary
Peritoneal Carcinoma
Akram M. Shaaban, MBBCh
EPITHELIAL

518 Serous Cystadenoma
Akram M. Shaaban, MBBCh, Marcia C. Javitt, MD, FACR, and Shephard S. Kosut, MD

524 Mucinous Cystadenoma
Akram M. Shaaban, MBBCh, Winnie Hahn, MD, and
Deborah Levine, MD, FACR

530 Adenofibroma and Cystadenofibroma
Akram M. Shaaban, MBBCh, Ilse Castro-Aragon, MD, and
Sandra J. Allison, MD

536 Ovarian Serous Carcinoma
Akram M. Shaaban, MBBCh and Oguz Akin, MD

542 Mucinous Carcinoma
Akram M. Shaaban, MBBCh, Oguz Akin, MD, and Deborah
Levine, MD, FACR

548 Seromucinous Ovarian Tumors
Akram M. Shaaban, MBBCh and Christine O. Menias, MD

554 Ovarian Endometrioid Carcinoma
Akram M. Shaaban, MBBCh

560 Ovarian Clear Cell Carcinoma
Akram M. Shaaban, MBBCh and Oguz Akin, MD

566 Carcinosarcoma (Ovarian Mixed Müllerian Tumor)
Akram M. Shaaban, MBBCh and Evis Sala, MD, PhD

570 Ovarian Brenner Tumors
Akram M. Shaaban, MBBCh
GERM CELL

576 Mature Cystic Teratoma (Dermoid Cyst)
Akram M. Shaaban, MBBCh, Sandra J. Allison, MD, and
Deborah Levine, MD, FACR

586 Immature Teratoma
Akram M. Shaaban, MBBCh and Evis Sala, MD, PhD

592 Dysgerminoma
Akram M. Shaaban, MBBCh and Oguz Akin, MD

598 Ovarian Yolk Sac Tumor
Akram M. Shaaban, MBBCh, Evis Sala, MD, PhD, and
Christine O. Menias, MD

602 Ovarian Choriocarcinoma
Akram M. Shaaban, MBBCh and Evis Sala, MD, PhD

606 Ovarian Carcinoid
Akram M. Shaaban, MBBCh, Evis Sala, MD, PhD, and
Christine O. Menias, MD

612 Ovarian Mixed Germ Cell Tumor and Embryonal
Carcinoma
Akram M. Shaaban, MBBCh

616 Struma Ovarii
Akram M. Shaaban, MBBCh
SEX CORD-STROMAL

622 Granulosa Cell Tumor
Akram M. Shaaban, MBBCh and Ilse Castro-Aragon, MD

628 Fibroma, Thecoma, and Fibrothecoma
Akram M. Shaaban, MBBCh, Mostafa Atri, MD, FRCPC,
Dipl Epid, and Caroline Reinhold, MD, MSc

634 Sertoli and Sertoli-Leydig Cell Tumors
Akram M. Shaaban, MBBCh and Christine O. Menias, MD

640 Sclerosing Stromal Tumor
Akram M. Shaaban, MBBCh and Evis Sala, MD, PhD
METASTASES AND HEMATOLOGICAL

644 Ovarian Metastases
Akram M. Shaaban, MBBCh and Oguz Akin, MD

650 Ovarian Lymphoma
Akram M. Shaaban, MBBCh and Oguz Akin, MD

SECTION 4: NONNEOPLASTIC OVARIAN LESIONS

658 Endometrioma
Maryam Rezvani, MD

668 Endometriosis
Maryam Rezvani, MD and Jeffrey Olpin, MD

678 Ovarian Hyperstimulation Syndrome
Marc S. Tubay, MD

682 Polycystic Ovary Syndrome
Maryam Rezvani, MD

688 Peritoneal Inclusion Cysts
Marc S. Tubay, MD
SECTION 5: VASCULAR

698 Ovarian Vein Thrombosis
Marc S. Tubay, MD and Akram M. Shaaban, MBBCh

704 Pelvic Congestion Syndrome
Douglas Rogers, MD

708 Acute Adnexal Torsion
Akram M. Shaaban, MBBCh

714 Massive Ovarian Edema and Fibromatosis
Akram M. Shaaban, MBBCh
Part VI: Fallopian Tubes
SECTION 1: CONGENITAL

722 Paratubal Cyst
Maryam Rezvani, MD

SECTION 2: INFLAMMATION/INFECTION

728 Pelvic Inflammatory Disease
Akram M. Shaaban, MBBCh and Maryam Rezvani, MD

738 Hydrosalpinx
Maryam Rezvani, MD

742 Genital Tuberculosis
Maryam Rezvani, MD

746 Actinomycosis
Maryam Rezvani, MD

750 Salpingitis Isthmica Nodosa
Paula J. Woodward, MD

SECTION 3: BENIGN NEOPLASMS

756 Tubal Leiomyoma
Maryam Rezvani, MD
SECTION 4: MISCELLANEOUS

762 Hematosalpinx
Maryam Rezvani, MD

Part VII: Multiorgan Disorders
SECTION 1: MALIGNANT NEOPLASMS

766 Genital Lymphoma
Douglas Rogers, MD

772 Genital Metastases
Douglas Rogers, MD

SECTION 2: ABNORMAL SEXUAL DEVELOPMENT

778 Complete Androgen Insensitivity Syndrome
Douglas Rogers, MD

780 Ambiguous Genitalia
Douglas Rogers, MD

784 Gonadal Dysgenesis
Douglas Rogers, MD

Part VIII: Pelvic Floor
SECTION 1: OVERVIEW

790 Anatomy of the Pelvic Floor
Rania Farouk El Sayed, MD, PhD

808 MR Imaging of the Pelvic Floor
Rania Farouk El Sayed, MD, PhD

SECTION 2: PELVIC FLOOR DYSFUNCTION ANTERIOR COMPARTMENT

814 Anatomy of Bladder and Urethral Support
Rania Farouk El Sayed, MD, PhD

832 MR Imaging of Stress Urinary Incontinence
Rania Farouk El Sayed, MD, PhD
MIDDLE COMPARTMENT

838 Anatomy of Uterocervical and Vaginal Support
Rania Farouk El Sayed, MD, PhD

850 MR Imaging of Pelvic Organ Prolapse
Rania Farouk El Sayed, MD, PhD
POSTERIOR COMPARTMENT

858 Anatomy of Anal Canal and Anal Sphincter Complex
Rania Farouk El Sayed, MD, PhD

872 MR Imaging of Fecal Incontinence
Rania Farouk El Sayed, MD, PhD

880 MR Imaging of Obstructed Defecation
Rania Farouk El Sayed, MD, PhD
MULTICOMPARTMENTAL

892 Multicompartmental Imaging
Rania Farouk El Sayed, MD, PhD