Shusaku Yoshida

Pathologies of the uterine endometrial cavity: usual and unusual manifestations and pitfalls on magnetic resonance imaging

The endometrial cavity may demonstrate various imaging manifestations such as normal, reactive, inflammatory, and benign and malignant neoplasms. We evaluated usual and unusual magnetic resonance imaging (MRI) findings of the uterine endometrial cavity, and described the diagnostic clues to differential diagnoses. Surgically proven pathologies of the uterine endometrial cavity were evaluated retrospectively with pathologic correlation. The pathologies included benign endometrial neoplasms such as endometrial hyperplasia and polyp, malignant endometrial neoplasms such as endometrial carcinoma and carcinosarcoma, endometrial–myometrial neoplasm such as endometrial stromal sarcoma, pregnancy-related lesions in the endometrial cavity such as gestational trophoblastic diseases (hydatidiform mole, invasive mole and choriocarcinoma) and placental polyp, myometrial lesions simulating endometrial lesions such as submucosal leiomyoma and some adenomyosis, endometrial neoplasms simulating myometrial lesions such as adenomyomatous polyp and endometrial lesions arising in the hemicavity of a septate/bicornate uterus, and fluid collections in the uterine cavity (hydro/hemato/pyometra). It is important to recognize various imaging findings in these diseases, in order to make a correct preoperative diagnosis.

Imaging findings of urachal mucinous cystadenocarcinoma associated with pseudomyxoma peritonei

Pseudomyxoma peritonei is an uncommon neoplastic condition in which gelatinous fluid‐like materials are observed in the peritoneal cavity caused by the dissemination of mucinous adenocarcinoma. Although ruptured appendiceal mucocele is the most common cause, tumors arising from other organs may also cause pseudomyxoma peritonei. We report the imaging findings of an extremely rare case of urachal mucinous adenocarcinoma associated with pseudomyxoma peritonei on computed tomography and magnetic resonance imaging with histopathologic correlation.

Adenosarcoma of the uterus: magnetic resonance imaging characteristics

Adenosarcoma of the uterus is a rare tumor containing benign glandular epithelial and malignant mesenchymal elements. Typical adenosarcoma is a low-grade tumor, presents as a large polypoid mass occupying the endometrial cavity, and may protrude into the vaginal cavity. The presence of small hyperintense cysts scattered within the mass on T(2)-weighted imaging, reflecting glandular epithelial components, and relatively low signal intensity on high b-value diffusion-weighted imaging, reflecting its low-grade nature, may be characteristic findings.

Localized pseudomyxoma peritonei in the female pelvis simulating ovarian carcinomatous peritonitis

Two cases of localized pseudomyxoma peritonei in the female pelvic cavity associated with a ruptured appendiceal mucocele and ovarian involvement that mimicked ovarian carcinomatous peritonitis were evaluated. Subtle omental irregularity adjacent to the cecum may suggest the hidden appendiceal origin reflecting localized carcinomatous peritonitis caused by the occult rupture of the mucocele. Mucinous fluid-like materials were localized in the pelvic cavity with scalloping of the uterus, which may be the diagnostic finding of pseudomyxoma peritonei.

Early clinical experience on cone-beam CT

ConclusionThis system is really non-invasive, relatively low in X-ray exposure, and is able to obtain fruitful informations from many directions. Therefore conebeam CT is considered as a suitable modality for the demonstration of high contrasted structures and subsequently provides the beneficial informations to the therapeutic approaches. This system may take place of conventional X-ray tomography if the cost-down becomes feasible.