Jalal Jalal Shokouhi-MD Radiologist, Jam e jam and koorosh medical imaging center General secretary...

Jalal Jalal Shokouhi-MD Radiologist, Jam e jam and koorosh medical imaging center

General secretary of Iranian society of radiology - President of Iranian radiologic cooperativeHasan Joorabchi-MD OB & GY, Tabriz medical university, IranMohammad Hossein Herischi – MD Orthopedist, Baku, Republic AzerbayjanShahyar Pashaie – PhD Anatomist, Tehran, Iran Dariush Etemadi –MD Radiologist, Koorosh medical imaging center, Tehran, Iran

jalaljalalshokouhi@hotmail.com www.medimage.ir

Women's imagingWomen's imaging

Pelvic pain Pelvic pain MRI in chronic pelvic pain (C.P.P.)MRI in chronic pelvic pain (C.P.P.)

1/3 of women pelvic pain in lifetime Most common complain Most difficult to diagnosis and manage 60% (three of five) never find out the cause of their

pelvic pain

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Women seek help from: Gynecologists Urologists Family practitioners

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Pelvic masses

PET/CT technique & imaging issues

Low midline pelvic mass

Prolapsing Leiomyoma Mucinous Rectal Cancer

Anorectal Mass

Prolapsing rectal cancer Rectum duplication cyst

Chronic pelvic pain:Any pelvic pain lasting more than six months1 woman of five women (20% incidence)It is a non specific pain (acute pain may indicate a specific

injury)Cause: change in nervous system, tissues or muscles

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Sacral teratoma

Sacral Masses

Anterior Meningocele Sacrococcygeal chordoma

Signs and symptoms:1. Severe and steady pain (dull to sharp,

mild to severe)2. Pain that comes and goes (intermittent)3. Sharp pains or cramping4. Dull aching5. Limited physical activity6. Pressure or heaviness deep within pelvis7. Painful intercourse8. Pain when urination and bowel movement9. Severe cramping during periods10. Depression and hopelessness and

addiction

Accurate diagnosis: Pelvic exam Cultures of excretions Pelvic ultrasound and sonohisterography (TA, TV ,TR) Laparascopy X-ray, X-ray CT, CT PET MRI (most accurate)

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Hemangioma, Pelvis

Hemangiopericytoma Liposarcoma

Pelvic congestion syndrome

Pelvic congestion syndromePelvic congestion syndrome

Lymphadenopathy

CYSTIC ADENOMYOSIS

ADENOMYOSIS

Cervical cancer

Cervical cancer

URETHRAL ANATOMY & IMAGING ISSUE

Vaginal fistula

Pelvic MRI: Non-invasive 3 Dimensional (x-y-z) Accurate Gives vital information Uncover, covered conditions Elegant imaging technology Diagnosis and staging Can diagnose pelvic floor lesions T1 - T2 - T1,F.S - T1,GD - 3D,GRE - T1 dynamic - MR

lymphangiography MR PET

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MUCINOUS CYSTADENOMA

PELVIC FLOOD DESCENT

MR TECHNIQUE & ANATOMY

Interventional treatments: Acupuncture Biofeed back and relaxation therapies Nerve stimulation devices Local anesthesia injection in tender areas Help women who have become dependent on

narcotics Fibroid embolization

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