[Magnetic resonance of the female pelvis]. / Resonancia magnética de la pelvis femenina.

OBJECTIVE: To analyze the utility of magnetic resonance imaging (MRI) in the assessment of the female pelvis, with special reference to the technical aspects. METHODS: Our experience and the literature on MRI in the evaluation of the female pelvis are reviewed. RESULTS/CONCLUSIONS: Conventional MRI assessment, which includes T1- and T2-weighted images in the axial, sagittal and coronal planes and T2 acquisitions along the major axis of the uterus in the sagittal plane, has proved effective in evaluating different pathologies of the female pelvis. MRI is particularly effective in staging endometrial carcinoma and in determining myometrial or cervical invasion. It is also useful in determining parametrial invasion in cervical carcinoma. In ovarian disease, MRI has been used in detecting peritoneal involvement, adenopathies and to characterize the lesion. It is particularly useful for planning the surgical approach in congenital disease. The high resolution of MRI with the use of the new coils has enhanced its efficiency and effectiveness in the diagnosis of congenital anomalies and tumors of the female urethra, and in the evaluation of prolapse of the urinary bladder and urinary incontinence.

[Local staging with CT of tumors of the upper urothelium]. / Estadiaje local mediante TC de los tumores del urotelio superior.

OBJECTIVE: To evaluate the ability of computerized tomography (CT) to stage transitional cell carcinoma of the upper urinary tract. METHODS: 29 transitional cell carcinoma of the upper urinary tract submitted to nephroureterectomy were retrospectively evaluated. All 29 tumors had preoperative CT scans performed to stage the lesion. The pathological staging was compared to that of CT. RESULTS: 10 of the 29 tumors had CT evidence of tumor extension and 19 had localized noninvasive tumor on CT. Of the 10 patients with CT findings of tumor extension, 2 (20%) had superficial tumors and 8 (80%) had tumors that invaded into the adventitial fat, renal parenchyma or perirenal fat (pT3, pT4). Of the 19 patients with localized noninvasive tumor on CT, 13 (68%) had superficial tumors and 6 (32%) had pT3 or pT4 tumors. CT sensitivity for tumor invasion was 57% with a specificity of 87.5%. CONCLUSIONS: Our analysis shows that CT is of limited value in staging these tumors. When CT demonstrates direct tumor extension through the renal pelvic or ureteral wall, it is a sensitive indicator of high-stage tumor. However, the results obtained in low stage tumors must be viewed with caution.