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Pitfalls em radiologia ginecológica
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Abstract(s)
Para o diagnóstico radiológico das patologias
ginecológicas é essencial conhecer e compreender
as indicações dos vários exames disponíveis e,
para cada achado radiológico, integrar a idade,
o contexto clínico e a história pregressa da
doente. A Ressonância Magnética (RM) tem hoje
um papel crucial no diagnóstico das doenças
ginecológicas. Contudo, para maximizar o
potencial desta técnica é imprescindível adequar
o protocolo utilizado a cada caso e a cada doente
e ter em conta algumas regras imprescindíveis
à interpretação dos exames, que descreveremos
neste artigo.
A RM ginecológica é principalmente útil no
estadiamento do carcinoma do colo do útero
e do endométrio, podendo por vezes ser
também útil na sua detecção, na avaliação da
resposta ao tratamento, detecção da recidiva ou
complicações e na avaliação de lesões anexiais
de natureza indeterminada na ecografia. Nas
doenças benignas é frequentemente usada na
avaliação pré-terapêutica de leiomiomas uterinos,
bem como na adenomiose e na endometriose.
Em muitas destas situações há potenciais erros
e pitfalls, para os quais o médico radiologista
deve estar alerta, de forma a minimizar eventuais
falhas diagnósticas ou erros de estadiamento.
In gynaecologic imaging it is crucial to choose the most appropriate imaging method for each situation, as well as combining imaging findings with the age, clinical picture and previous clinical history of the patients. Magnetic resonance imaging (MRI) is currently indispensable in the diagnosis of gynaecological diseases. However, to take advantage of this technique, the use of adequate protocols is mandatory, specially designed for each patient and each clinical problem. On the other hand, the radiologist should bear in mind some critical rules and interpretation pearls, that we aim to describe in this paper. Gynaecologic MRI has a role to play in cervical and endometrial cancer staging, and sometimes also in tumour detection, in response evaluation after treatment and detection of recurrence and complications, and in the evaluation of indeterminate adnexal masses on ultrasonography. In benign disease, it is mainly used in the pre-therapeutic evaluation of uterine leiomyomas, as well as in adenomyosis and endometriosis. In each situation the radiologist has to be aware of potential pitfalls, to avoid diagnostic and staging errors.
In gynaecologic imaging it is crucial to choose the most appropriate imaging method for each situation, as well as combining imaging findings with the age, clinical picture and previous clinical history of the patients. Magnetic resonance imaging (MRI) is currently indispensable in the diagnosis of gynaecological diseases. However, to take advantage of this technique, the use of adequate protocols is mandatory, specially designed for each patient and each clinical problem. On the other hand, the radiologist should bear in mind some critical rules and interpretation pearls, that we aim to describe in this paper. Gynaecologic MRI has a role to play in cervical and endometrial cancer staging, and sometimes also in tumour detection, in response evaluation after treatment and detection of recurrence and complications, and in the evaluation of indeterminate adnexal masses on ultrasonography. In benign disease, it is mainly used in the pre-therapeutic evaluation of uterine leiomyomas, as well as in adenomyosis and endometriosis. In each situation the radiologist has to be aware of potential pitfalls, to avoid diagnostic and staging errors.
Description
Keywords
Pélvis RM Ginecologia Estadiamento neoplasias Pelvis MRI Gynecology Neoplasm staging
Citation
Elsa Rosado; Teresa Margarida Cunha. Pitfalls in Gynaecologic Imaging, Acta Radiológica Portuguesa, 27, 105, 27-41, 2015.