الفهرس 
GROSS ANATOMYOnly 14 pages are availabe for public view
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Abstract
Endometrial cancer is the most common gynaecological malignancy and the incidence rising. Prognosis depends on age of patients, histological grade, depth of myometrial invasion and cervical invasion and lymph node metastases. Myometrial invasion and accurate cervical involvement cannot be predicted clinically. Modern imaging (including contrast-enhanced MRI) provides important tools in the accurate pre-treatment assessment of endometrial cancer and may optimize treatment planning.
Successful treatment of most patients with endometrial cancer requires proper identification of the primary tumor and demonstration of its local and regional extent. It is crucial that imaging procedures are tailored to precisely answer the clinical questions so that appropriate treatment can be selected.
TVS may reliably be utilized for the detection of endometrial carcinoma as well as for the preoperative assessment of tumor size, presence of ascites and adnexal metastases. It is less reliable for the assessment of cervical invasion or involvement of other organs such as the bladder, intestines or peritoneum. Therefore, further studies on the value of a combination of TVS and MRI in the preoperative setting of patients with endometrial cancer are warranted.
Magnetic resonance imaging (MRI) has emerged as an important imagiologic modality in the evaluation of the extension of endometrial carcinoma, showing to be important in assessing myometrial and, to a lesser extent, also cervical and lymph node infiltration.
MRI seems to be slightly superior to TVS in evaluating myometrial invasion. However, as it is expensive and time-consuming, MRI may not be suggested as a routine imaging modality for detection of myometrial invasion depth. On the other hand, TVS is relatively low-cost, easily performed, and repeated technique for assessment of myometrial invasion. The personal experience and familiarity of the radiologist with TVS is more important than MRI to achieve high accuracy.
Uterine cancers can be delineated on MRI, where T2WIs and dynamic 3D contrast-enhanced images provide good definition of the primary lesion and its extrauterine extension. A successful examination relies on good patient preparation, antiperistaltic agent use, and a scrupulous scanning technique. The multiplanar capabilities of MRI are invaluable for assessing disease margins and spread, and the 3D dynamic techniques offer the advantages of increased coverage and high spatial resolution. As MRI has excellent soft tissue contrast, it has become the standard for imaging uterine malignancies, providing a comprehensive assessment of disease before implementing potentially curative treatments such as surgery and radiotherapy. Characteristic MRI features can help refine the differential diagnosis, but the management plan ultimately depends on a combination of clinical factors, imaging findings, and histological features of the cancer.
Conclusion
The ultimate goal is to obtain accurate staging and early disease detection to provide optimal treatment and minimize morbidity and mortality. In endometrial cancer, MRI provides accurate preoperative evaluation of myometrial and cervical invasion allowing selective preoperative scheduling of lymphadenectomy.
MRI imaging coupled with contrast-enhanced dynamic technique is highly accurate in local-regional staging of endometrial carcinoma and can be used reliable for treatment planning.