RSNA News - October 2004

Journal Highlights

Müllerian Duct Anomalies: Imaging and Clinical Issues

Müllerian duct anomalies encompass a wide spectrum of clinical and imaging findings. While many of the anomalies will be diagnosed initially at hysterosalpingography or 2D ultrasound, further imaging with MR and potentially 3D ultrasound will often be required for a definitive diagnosis.

In an article in the State of the Art section of the October issue of Radiology (rsna.org/radiologyjnl), Robert N. Troiano, M.D., from Weill Medical College of Cornell University, and Shirley M. McCarthy, M.D., Ph.D., from Yale University School of Medicine, explain why müllerian duct anomalies are clinically important, particularly in women who present with infertility. They also discuss the importance of understanding the differences between uterovaginal anomalies and reporting certain anomalies, particularly those with features of more than one class.

"MR imaging currently is the study of choice because of its high accuracy and detailed elaboration of uterovaginal and ovarian anatomy," they write. "Laparoscopy and hysteroscopy are then reserved for women in whom interventional therapy is being undertaken, thus reducing health care expenditures and sparing women invasive diagnostic procedures."

This article also includes "Essentials" or highlighted points to help busy readers recognize important information at a glance.

To access this article online, go to radiology.rsnajnls.org.

(a) Septate uterus. HSG image shows wide divergence of opacified endometrial cavities simulating a bicornuate configuration.		(b) Corresponding coronal oblique fast spin-echo T2-weighted MR image (6000/120 [effective]) demonstrates insinuated leiomyoma (long arrow) within the septum, causing exaggerated separation of cavities. Note lateral wall myoma with cystic degeneration (short arrow) also causing distortion of left endometrial cavity.

(Radiology 2004; 232:19-34)
© 2004 RSNA. All rights reserved. Printed with permission.

 

Reconsideration of Pacemakers and MR Imaging

The technological evolution of the pacemaker is challenging the dogma of prohibiting pacemakers in the MR imaging environment.

In the September-October issue of RadioGraphics (rsna.org/radiographics), John Loewy, M.D., from the Department of Medical Imaging at Humber River Regional Hospital in Toronto, and colleagues review:

• Changes in pacemaker technology
• Case and anecdotal reports
• Results of large prospective clinical trials

The researchers write: "Preliminary evidence from controlled trials suggests that patients with a demand pacemaker can be studied under carefully controlled conditions, especially in areas more distant from the chest such as the brain and the knee. Surely the time has come when individually tailored MR imaging examinations may be considered for pacemaker patients. … Is it not time that the radiology community engaged in a large multicenter trial to settle this matter with scientific rigor?"
(RadioGraphics 2004;1257-1267)