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Bildgebende Diagnostik der inneren weiblichen Genitalorgane

  • R. A. Kubik-Huch
  • T. M. Keller
  • D. Fink
  • J. Scheidler
  • J. Wisser
Chapter
  • 40 Downloads
Part of the Handbuch diagnostische Radiologie book series (HDR)

Zusammenfassung

Der transvaginale Ultraschall (US) ist die Methode der Wahl für die bildgebende Untersuchung des weiblichen Genitaltraktes. Er ergänzt und objektiviert die klinische gynäkologische Untersuchung. Computertomographie (CT) und Magnetresonanztomographie (MRT) werden bei bestimmten Fragestellungen, wie bei angeborenen Fehlbildungen, bei Komplikationen entzündlicher Erkrankungen und zur präoperativen Stadieneinteilung bei Karzinomen ergänzend eingesetzt. Aufgrund des im Vergleich zur CT besseren Weichteilkontrastes hat vor allem die MRT bei der Abklärung solcher Fälle an Bedeutung gewonnen. Insbesondere sind die präoperative Stadieneinteilung beim Zervix- und Endometriumkarzinom sowie die Beurteilung von unklaren Raumforderungen des Ovars heute wichtige Indikationen für den Einsatz der MRT. Außerdem ist diese bei Patientinnen im gebärfähigen Alter sowie bei Schwangeren (s. Abschn. 4.2) geeignet, da eine Belastung mit ionisierenden Strahlen so vermieden werden kann.

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Literatur

  1. Abramowicz JS, Kossoff G, Marsal K, TerHaar G (2000) Safety statement 2000. Ultrasound Obstet Gynecol 16: 594–596CrossRefGoogle Scholar
  2. Ascher SM, Agrawal R, Bis KG et al. (1995): Endometriosis: Appearance and detection with conventional and contrastenhanced fat-suppressed spin-echo techniques. J Magn Reson Imaging 5: 251–257PubMedCrossRefGoogle Scholar
  3. Atri M, Nazarnia S, Aldis AE, Reinhold C, Bret PM, Kintzen G (1994) Transvaginal US appearance of endometrial abnormalities. Radiographics 14: 483–492PubMedGoogle Scholar
  4. Aultman CJ (1995) MR imaging of sonographically indetermine adnexal masses: Cost-benefit study. Radiology 197:354Google Scholar
  5. Baker PN, Johnson IR, Harvey PR, Gowland PA, Mansfield P (1994) A three-year follow-up of children imaged in utero with echo-planar magnetic resonance. Am J Obstet Gynecol 170: 32–33PubMedGoogle Scholar
  6. Boni RA, Hebisch G, Huch A, Stallmach T, Krestin GP (1994) Multiple necrotic uterine leiomyomas causing severe puerperal fever: Ultrasound, CT, MR, and histological findings. J Comput Assist Tomogr 18: 828–831PubMedCrossRefGoogle Scholar
  7. Bonnet D, Coltri A, Butera G et al. (1999) Detection of transposition of the great arteries in fetuses reduces neonatal morbidity and mortality. Circulation 99: 916–918PubMedCrossRefGoogle Scholar
  8. Buttram VC Jr, Gibbons WE (1979) Mullerian anomalies: A proposed classification. (An analysis of 144 cases). Fertil Steril 32: 40–46PubMedGoogle Scholar
  9. Coakley FV, Varghese SL, Hricak H (1999) CT and MRI of pelvic varices in women. J Comput Assist Tomogr 23: 429–434PubMedCrossRefGoogle Scholar
  10. Curtis M, Hopkins MP, Zarlingo T, Martino C, GracianskyLengyl M, Jenison EL (1993) Magnetic resonance imaging to avoid laparotomy in pregnancy. Obstet Gynecol 82: 830–836Google Scholar
  11. Demas BE, Hricak H, Jaffe RB (1986) Uterine MR imaging: Effects of hormonal stimulation. Radiology 159: 123–126PubMedGoogle Scholar
  12. Forstner R, Hricak H, Occhipinti KA et al. (1995 a) Ovarian cancer: Staging with CT and MR imaging. Radiology 197: 619–626PubMedGoogle Scholar
  13. Forstner R, Hricak H, Powell CB et al. (1995 b) Ovarian cancer recurrence: Value of MR imaging. Radiology 196: 715–720PubMedGoogle Scholar
  14. Goodman A, Hill EC (1994) Premalignant and malignant disorders of the uterine cervix. Appleton &; LangeGoogle Scholar
  15. Gullo G, Russ PD (2000) Pelvic varices diagnosed with endorectal surface coil magnetic resonance imaging: Case report. Can Assoc Radiol J 51: 23–27PubMedGoogle Scholar
  16. Ha HK, Lim YT, Kim HS et al. (1994) Diagnosis of pelvic endometriosis: Fat-suppressed T1-weighted vs conventional MR images. AIR Am J Roentgenol 163: 127–131Google Scholar
  17. Hamm B, Kubik-Huch RA, Fleige B (1999) MR imaging and CT of the female pelvis: Radiologic-pathologic correlation. Eur Radiol 9: 3–15PubMedCrossRefGoogle Scholar
  18. Hermanek P (Hrsg) (1988) TNM-Atlas. Illustrierter Leitfaden zur TNM/pTNM-Klassifikation maligner Tumoren, 4. Aufl. Springer, Berlin Heidelberg New York TokyoGoogle Scholar
  19. Hricak H, Finck S, Honda G, Goranson H (1992) MR imaging in the evaluation of benign uterine masses: Value of gadopentetate dimeglumine-enhanced T1-weighted images. AJR Am J Roentgenol 158: 1043–1050PubMedGoogle Scholar
  20. Hricak H, Powell CB, Yu KK et al. (1996) Invasive cervical carcinoma: Role of MR imaging in pretreatment work-up-cost minimization and diagnostic efficacy analysis. Radiology 198: 403–409PubMedGoogle Scholar
  21. Hricak H, Chen M, Coakley FV et al. (2000) Complex adnexal masses: Detection and characterization with MR imaging — multivariate analysis. Radiology 214: 39–46PubMedGoogle Scholar
  22. Hubbard AM, Adzick NS, Crombleholme TM et al. (1999) Congenital chest lesions: Diagnosis and characterization with prenatal MR imaging. Radiology 212: 43–48PubMedGoogle Scholar
  23. Huch-Boni RA, Heusler RH, Hebisch G, Krestin GP (1994) CT und MRT bei Entzündungen der weiblichen Genitalorgane. Radiologe 34: 390–396PubMedGoogle Scholar
  24. McCarthy S, Scott G, Majumdar S et al. (1989) Uterine junctional zone: MR study of water content and relaxation properties. Radiology 171: 241–243PubMedGoogle Scholar
  25. Kanal E, Gillen J, Evans JA, Savitz DA, Shellock FG (1993) Survey of reproductive health among female MR workers. Radiology 187: 395–399PubMedGoogle Scholar
  26. Kay HH, Spritzer CE (1991) Preliminary experience with magnetic resonance imaging in patients with third-trimester bleeding. Obstet Gynecol 78: 424–429PubMedGoogle Scholar
  27. Keller TM, Rake A, Michel SCA et al. (2003) Obstetric MR pelvimetry: Reference values and evaluation of inter- and intraobserver error and intraindividual variability. Radiology 227: 37–43PubMedCrossRefGoogle Scholar
  28. Kido A, Togashi K, Konishi I et al. (1999) Dermoid cysts of the ovary with malignant transformation: MR appearance. AJR Am J Roentgenol 172: 445–449PubMedGoogle Scholar
  29. Kim JC, Kim SS, Park JY (2000) „Bridging vascular sign“ in the MR diagnosis of exophytic uterine leiomyoma. J Comput Assist Tomogr 24: 57–60PubMedCrossRefGoogle Scholar
  30. Koelble N, Sobetzko D, Wisser J et al. (2002) Thanatophoric dysplasia-different phenotypes with identical mutations in FGFR3. Ultrasound Obstet GynecolGoogle Scholar
  31. Komatsu T, Konishi I, Mandai M et al. (1996) Adnexal masses: Transvaginal US and gadolinium-enhanced MR imaging assessment of intratumoral structure. Radiology 198: 109–115Google Scholar
  32. Kubik-Huch RA, Huisman TA, Wisser J et al. (2000) Ultrafast MR imaging of the fetus. AJR Am J Roentgenol 174: 1599–1606PubMedGoogle Scholar
  33. Kubik-Huch RA, Wildermuth S, Cettuzzi L et al. (2001) Fetus and uteroplacental unit: Fast MR imaging with threedimensional reconstruction and volumetry — feasibility study. Radiology 219: 567–573PubMedGoogle Scholar
  34. Levine D, Barnes PD, Sher S et al. (1998) Fetal fast MR imaging: Reproducibility, technical quality, and conspicuity of anatomy. Radiology 206: 549–554PubMedGoogle Scholar
  35. Loon AJ van, Mantingh A, Serlier EK, Kroon G, Mooyaart EL, Huisjes HJ (1997) Randomised controlled trial of magnetic-resonance pelvimetry in breech presentation at term. Lancet 350: 1799–1804PubMedCrossRefGoogle Scholar
  36. Nguyen C, Montz FJ, Bristow RE (2000) Management of stage I cervical cancer in pregnancy. Obstet Gynecol Sury 55: 633–643CrossRefGoogle Scholar
  37. Pellerito JS, McCarthy SM, Doyle MB, Glickman MG, De Cherney AH (1992) Diagnosis of uterine anomalies: Relative accuracy of MR imaging, endovaginal sonography, and hysterosalpingography. Radiology 183: 795- 800PubMedGoogle Scholar
  38. Rofsky NM, Pizzarello DJ, Weinreb L, Ambrosino MM, Rosenberg C (1994) Effect on fetal mouse development of exposure to MR imaging and gadopentetate dimeglumine. J Magn Reson Imaging 4: 805–807PubMedCrossRefGoogle Scholar
  39. Roy C, Saussine C, Jahn C et al. (1995) Fast imaging MR assessment of ureterohydronephrosis during pregnancy. Magn Reson Imaging 13: 767–772PubMedCrossRefGoogle Scholar
  40. Scheidler J, Heuck AF, Meier W, Reiser MF (1997) MRI of pelvic masses: Efficacy of the rectal superparamagnetic contrast agent Ferumoxsil. J Magn Reson Imaging 7: 1027–1032PubMedCrossRefGoogle Scholar
  41. Schwartz LB, Panageas E, Lange R et al. (1994) Female pelvis: Impact of MR imaging on treatment decisions and net cost analysis. Radiology 192: 55–60PubMedGoogle Scholar
  42. Scoutt LM, McCarthy SM, Lange R, Bourque A, Schwartz PE (1994) MR evaluation of clinically suspected adnexal masses. J Comput Assist Tomogr 18: 609–618PubMedCrossRefGoogle Scholar
  43. Sironi S, De Cobelli F, Scarfone G et al. (1993) Carcinoma of the cervix: Value of plain and gadolinium-enhanced MR imaging in assessing degree of invasiveness. Radiology 188: 797–801PubMedGoogle Scholar
  44. Stevens SK, Hricak H, Campos Z (1993) Teratomas versus cystic hemorrhagic adnexal lesions: Differentiation with proton-selective fat-saturation MR imaging. Radiology 186: 481–488PubMedGoogle Scholar
  45. Tanaka YO, Itai Y, Anno I et al. (1996) MR staging of pelvic endometriosis: Role of fat-suppression T1-weighted images. Radiat Med 14: 111–116PubMedGoogle Scholar
  46. Taylor KJ, Schwartz PE (1994) Screening for early ovarian cancer. Radiology 192: 1–10PubMedGoogle Scholar
  47. Togashi K, Ozasa H, Konishi I et al. (1989) Enlarged uterus: Differentiation between adenomyosis and leiomyoma with MR imaging. Radiology 171: 531–534PubMedGoogle Scholar
  48. UICC/International Union against Cancer (1997) TNM-Klassifikation maligner Tumoren, 5. Aufl. Springer, Berlin Heidelberg New York TokyoGoogle Scholar
  49. Weinreb JC, Brown CE, Lowe TW, Cohen JM, Erdman WA (1986) Pelvic masses in pregnant patients: MR and US imaging. Radiology 159: 717–724PubMedGoogle Scholar
  50. Weinreb JC, Barkoff ND, Megibow A, Demopoulos R (1990) The value of MR imaging in distinguishing leiomyomas from other solid pelvic masses when sonography is indeterminate. AJR Am J Roentgenol 154: 295–299PubMedGoogle Scholar
  51. Wiesner W, Kubik-Huch RA, Imthurn B, Marincek B (1998) Mayer-(von)Rokitansky-Kuster-Syndrom. Schweiz Rundsch Med Prax 87: 1257–1259Google Scholar
  52. Wiesner W, Ruehm SG, Bongartz G, Kaim A, Reese E, De Geyter C (2001) Three-dimensional dynamic MR hysterosalpingography: A preliminary report. Eur Radiol 11: 1439–1444PubMedCrossRefGoogle Scholar
  53. Wisser J (1995) Vaginalsonographie im ersten Schwangerschaftsdrittel. Springer, Berlin Heidelberg New York TokyoCrossRefGoogle Scholar
  54. Woodward PJ, Sohaey R, Mezzetti TP Jr (2001) Endometriosis: Radiologic-pathologic correlation. Radiographics 21: 193216; questionnaire 288–294Google Scholar
  55. Yamashita Y, Torashima M, Hatanaka Y et al. (1995) Adnexal masses: Accuracy of characterization with transvaginal US and precontrast and postcontrast MR imaging. Radiology 194: 557–565PubMedGoogle Scholar
  56. Yang WT, Lam WW, Yu MY, Cheung TH, Metreweli C (2000) Comparison of dynamic helical CT and dynamic MR imaging in the evaluation of pelvic lymph nodes in cervical carcinoma. AJR Am J Roentgenol 175: 759–766PubMedGoogle Scholar
  57. Zimmermann R, Dürig P (1997) Empfehlungen zur Ultraschall-Untersuchung in der Schwangerschaft. Arbeitstagung der Standardkommission für Schwangerschafts-Ultraschall. BernGoogle Scholar

Copyright information

© Springer-Verlag Berlin Heidelberg 2004

Authors and Affiliations

  • R. A. Kubik-Huch
  • T. M. Keller
  • D. Fink
  • J. Scheidler
  • J. Wisser

There are no affiliations available

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