Diagnostic Imaging: Gynecology

Part I: Techniques SECTION 1: PELVIS 4 Ultrasound Technique and Anatomy Douglas Rogers, MD and Marc S. Tubay, MD 10 Hysterosalpingography Douglas Rogers, MD and Marc S. Tubay, MD 16 Sonohysterography Akram M. Shaaban, MBBCh and Douglas Rogers, MD 20 CT Technique and Anatomy Marc S. Tubay, MD 24 MR Technique and Anatomy Marc S. Tubay, MD 30 PET/CT Technique and Imaging Issues Marc S. Tubay, MD Part II: Uterus SECTION 1: INTRODUCTION AND OVERVIEW 38 Anatomy of the Uterus Paula J. Woodward, MD and Akram M. Shaaban, MBBCh SECTION 2: AGE-RELATED CHANGES 60 Endometrial Atrophy Maryam Rezvani, MD, Jeffrey Olpin, MD, and Sandra J. Allison, MD SECTION 3: CONGENITAL 64 Introduction to Müllerian Duct Anomalies Akram M. Shaaban, MBBCh 68 Müllerian Agenesis Akram M. Shaaban, MBBCh, Nyree Griffin, MD, FRCR, and Caroline Reinhold, MD, MSc 74 Unicornuate Uterus Akram M. Shaaban, MBBCh, Nyree Griffin, MD, FRCR, and Caroline Reinhold, MD, MSc 80 Uterus Didelphys Akram M. Shaaban, MBBCh, Nyree Griffin, MD, FRCR, and Caroline Reinhold, MD, MSc 86 Bicornuate Uterus Akram M. Shaaban, MBBCh, Caroline Reinhold, MD, MSc, and Khashayar Rafatzand, MD, FRCPC 90 Septate Uterus Akram M. Shaaban, MBBCh and Susan M. Ascher, MD, FISMRM, FSCBT/MR

96 Arcuate Uterus Akram M. Shaaban, MBBCh, Nyree Griffin, MD, FRCR, and Evis Sala, MD, PhD 98 DES Exposure Akram M. Shaaban, MBBCh, Nyree Griffin, MD, FRCR, and Evis Sala, MD, PhD SECTION 4: INFLAMMATION/INFECTION 102 Asherman Syndrome, Endometrial Synechiae Douglas Rogers, MD and Christine O. Menias, MD 106 Endometritis Douglas Rogers, MD and Christine O. Menias, MD 110 Pyomyoma Douglas Rogers, MD SECTION 5: BENIGN NEOPLASMS MYOMETRIUM 116 Uterine Leiomyoma Maryam Rezvani, MD and Jeffrey Olpin, MD 122 Leiomyomas: Degeneration, Variants, and Complications Marc S. Tubay, MD and Jeffrey Olpin, MD 130 Benign Metastasizing Leiomyoma Akram M. Shaaban, MBBCh and Winnie Hahn, MD 132 Diffuse Leiomyomatosis Douglas Rogers, MD and Christine O. Menias, MD 134 Intravenous Leiomyomatosis Douglas Rogers, MD 138 Disseminated Peritoneal Leiomyomatosis Douglas Rogers, MD and Christine O. Menias, MD 142 Lipomatous Uterine Tumors Douglas Rogers, MD and Christine O. Menias, MD ENDOMETRIUM 146 Endometrial Polyps Maryam Rezvani, MD and Jeffrey Olpin, MD 152 Endometrial Hyperplasia Maryam Rezvani, MD and Jeffrey Olpin, MD SECTION 6: MALIGNANT NEOPLASMS ENDOMETRIUM 158 Corpus Uteri Carcinoma Maryam Rezvani, MD 174 Uterine Adenosarcoma Douglas Rogers, MD 178 Endometrial Stromal Sarcoma Douglas Rogers, MD

182 Uterine Carcinosarcoma Douglas Rogers, MD 186 Gestational Trophoblastic Neoplasms Akram M. Shaaban, MBBCh MYOMETRIUM 196 Uterine Leiomyosarcoma Douglas Rogers, MD SECTION 7: VASCULAR 202 Uterine Arteriovenous Malformation Maryam Rezvani, MD and Jeffrey Olpin, MD 208 Uterine Artery Embolization Imaging Jeffrey Olpin, MD and Maryam Rezvani, MD SECTION 8: TREATMENT-RELATED CONDITIONS 216 Tamoxifen-Induced Changes Jeffrey Olpin, MD and Maryam Rezvani, MD 222 Contraceptive Device Evaluation Maryam Rezvani, MD and Jeffrey Olpin, MD 230 Post Cesarean Section Appearance Maryam Rezvani, MD and Jeffrey Olpin, MD SECTION 9: ADENOMYOSIS 236 Adenomyosis Jeffrey Olpin, MD and Maryam Rezvani, MD 242 Adenomyoma Maryam Rezvani, MD and Jeffrey Olpin, MD 246 Cystic Adenomyosis Maryam Rezvani, MD and Jeffrey Olpin, MD Part III: Cervix SECTION 1: INTRODUCTION AND OVERVIEW 252 Anatomy of the Cervix Marc S. Tubay, MD SECTION 2: INFECTION/INFLAMMATION 260 Cervical Stenosis Douglas Rogers, MD SECTION 3: BENIGN NEOPLASMS 266 Endocervical Polyp Douglas Rogers, MD 270 Cervical Leiomyoma Douglas Rogers, MD SECTION 4: MALIGNANT NEOPLASMS 276 Corpus Uteri Sarcoma Maryam Rezvani, MD 288 Cervix Uteri Carcinoma Maryam Rezvani, MD 308 Adenoma Malignum Douglas Rogers, MD

312 Cervical Sarcoma Douglas Rogers, MD 316 Cervical Melanoma Akram M. Shaaban, MBBCh, Nyree Griffin, MD, FRCR, and Evis Sala, MD, PhD SECTION 5: TREATMENT-RELATED CONDITIONS 322 Posttrachelectomy Appearances Maryam Rezvani, MD and Jeffrey Olpin, MD SECTION 6: MISCELLANEOUS 326 Cervical Glandular Hyperplasia Maryam Rezvani, MD and Jeffrey Olpin, MD 330 Nabothian Cysts Maryam Rezvani, MD and Jeffrey Olpin, MD Part IV: Vagina and Vulva SECTION 1: INTRODUCTION AND OVERVIEW 336 Vaginal and Vulvar Anatomy Marc S. Tubay, MD SECTION 2: CONGENITAL 346 Lower Vaginal Atresia Douglas Rogers, MD 348 Imperforate Hymen Douglas Rogers, MD 350 Vaginal Septa Douglas Rogers, MD SECTION 3: BENIGN NEOPLASMS 354 Vaginal Leiomyoma Akram M. Shaaban, MBBCh, Olga Hatsiopoulou, MD, FRCR, and Evis Sala, MD, PhD 360 Vulvar Slow-Flow Vascular Malformation Douglas Rogers, MD 364 Vaginal Paraganglioma Douglas Rogers, MD SECTION 4: MALIGNANT NEOPLASMS 370 Vaginal Carcinoma Akram M. Shaaban, MBBCh 382 Vaginal Leiomyosarcoma Akram M. Shaaban, MBBCh, Olga Hatsiopoulou, MD, FRCR, and Evis Sala, MD, PhD 384 Embryonal Rhabdomyosarcoma Douglas Rogers, MD 388 Vaginal Yolk Sac Tumor Akram M. Shaaban, MBBCh, Olga Hatsiopoulou, MD, FRCR, and Evis Sala, MD, PhD 392 Bartholin Gland Carcinoma Douglas Rogers, MD 396 Vulvar Carcinoma Maryam Rezvani, MD

408 Vulvar Leiomyosarcoma Douglas Rogers, MD 410 Vulvar and Vaginal Melanoma Akram M. Shaaban, MBBCh and Evis Sala, MD, PhD 416 Aggressive Angiomyxoma Douglas Rogers, MD 420 Merkel Cell Tumor Douglas Rogers, MD SECTION 5: LOWER GENITAL CYSTS 424 Gartner Duct Cysts Marc S. Tubay, MD and Akram M. Shaaban, MBBCh 428 Bartholin Cysts Marc S. Tubay, MD and Akram M. Shaaban, MBBCh 434 Urethral Diverticulum Marc S. Tubay, MD and Akram M. Shaaban, MBBCh 438 Skene Gland Cyst Marc S. Tubay, MD and Akram M. Shaaban, MBBCh SECTION 6: MISCELLANEOUS 444 Vaginal Foreign Bodies Douglas Rogers, MD 452 Vaginal Fistula Marc S. Tubay, MD and Akram M. Shaaban, MBBCh Part V: Ovary SECTION 1: INTRODUCTION AND OVERVIEW 460 Anatomy of the Ovaries Paula J. Woodward, MD and Akram M. Shaaban, MBBCh SECTION 2: PHYSIOLOGIC AND AGERELATED CHANGES 470 Follicular Cyst Marc S. Tubay, MD 474 Corpus Luteum Marc S. Tubay, MD and Akram M. Shaaban, MBBCh 480 Theca Lutein Cysts Akram M. Shaaban, MBBCh, Patricia Noël, MD, FRCPC, and Caroline Reinhold, MD, MSc 484 Hemorrhagic Ovarian Cyst Paula J. Woodward, MD 490 Ovarian Inclusion Cyst Marc S. Tubay, MD SECTION 3: NEOPLASMS 498 Overview of Ovary, Fallopian Tube, and Primary Peritoneal Carcinoma Akram M. Shaaban, MBBCh EPITHELIAL 518 Serous Cystadenoma Akram M. Shaaban, MBBCh, Marcia C. Javitt, MD, FACR, and Shephard S. Kosut, MD

524 Mucinous Cystadenoma Akram M. Shaaban, MBBCh, Winnie Hahn, MD, and Deborah Levine, MD, FACR 530 Adenofibroma and Cystadenofibroma Akram M. Shaaban, MBBCh, Ilse Castro-Aragon, MD, and Sandra J. Allison, MD 536 Ovarian Serous Carcinoma Akram M. Shaaban, MBBCh and Oguz Akin, MD 542 Mucinous Carcinoma Akram M. Shaaban, MBBCh, Oguz Akin, MD, and Deborah Levine, MD, FACR 548 Seromucinous Ovarian Tumors Akram M. Shaaban, MBBCh and Christine O. Menias, MD 554 Ovarian Endometrioid Carcinoma Akram M. Shaaban, MBBCh 560 Ovarian Clear Cell Carcinoma Akram M. Shaaban, MBBCh and Oguz Akin, MD 566 Carcinosarcoma (Ovarian Mixed Müllerian Tumor) Akram M. Shaaban, MBBCh and Evis Sala, MD, PhD 570 Ovarian Brenner Tumors Akram M. Shaaban, MBBCh GERM CELL 576 Mature Cystic Teratoma (Dermoid Cyst) Akram M. Shaaban, MBBCh, Sandra J. Allison, MD, and Deborah Levine, MD, FACR 586 Immature Teratoma Akram M. Shaaban, MBBCh and Evis Sala, MD, PhD 592 Dysgerminoma Akram M. Shaaban, MBBCh and Oguz Akin, MD 598 Ovarian Yolk Sac Tumor Akram M. Shaaban, MBBCh, Evis Sala, MD, PhD, and Christine O. Menias, MD 602 Ovarian Choriocarcinoma Akram M. Shaaban, MBBCh and Evis Sala, MD, PhD 606 Ovarian Carcinoid Akram M. Shaaban, MBBCh, Evis Sala, MD, PhD, and Christine O. Menias, MD 612 Ovarian Mixed Germ Cell Tumor and Embryonal Carcinoma Akram M. Shaaban, MBBCh 616 Struma Ovarii Akram M. Shaaban, MBBCh SEX CORD-STROMAL 622 Granulosa Cell Tumor Akram M. Shaaban, MBBCh and Ilse Castro-Aragon, MD 628 Fibroma, Thecoma, and Fibrothecoma Akram M. Shaaban, MBBCh, Mostafa Atri, MD, FRCPC, Dipl Epid, and Caroline Reinhold, MD, MSc 634 Sertoli and Sertoli-Leydig Cell Tumors Akram M. Shaaban, MBBCh and Christine O. Menias, MD 640 Sclerosing Stromal Tumor Akram M. Shaaban, MBBCh and Evis Sala, MD, PhD METASTASES AND HEMATOLOGICAL 644 Ovarian Metastases Akram M. Shaaban, MBBCh and Oguz Akin, MD

650 Ovarian Lymphoma Akram M. Shaaban, MBBCh and Oguz Akin, MD SECTION 4: NONNEOPLASTIC OVARIAN LESIONS 658 Endometrioma Maryam Rezvani, MD 668 Endometriosis Maryam Rezvani, MD and Jeffrey Olpin, MD 678 Ovarian Hyperstimulation Syndrome Marc S. Tubay, MD 682 Polycystic Ovary Syndrome Maryam Rezvani, MD 688 Peritoneal Inclusion Cysts Marc S. Tubay, MD SECTION 5: VASCULAR 698 Ovarian Vein Thrombosis Marc S. Tubay, MD and Akram M. Shaaban, MBBCh 704 Pelvic Congestion Syndrome Douglas Rogers, MD 708 Acute Adnexal Torsion Akram M. Shaaban, MBBCh 714 Massive Ovarian Edema and Fibromatosis Akram M. Shaaban, MBBCh Part VI: Fallopian Tubes SECTION 1: CONGENITAL 722 Paratubal Cyst Maryam Rezvani, MD SECTION 2: INFLAMMATION/INFECTION 728 Pelvic Inflammatory Disease Akram M. Shaaban, MBBCh and Maryam Rezvani, MD 738 Hydrosalpinx Maryam Rezvani, MD 742 Genital Tuberculosis Maryam Rezvani, MD 746 Actinomycosis Maryam Rezvani, MD 750 Salpingitis Isthmica Nodosa Paula J. Woodward, MD SECTION 3: BENIGN NEOPLASMS 756 Tubal Leiomyoma Maryam Rezvani, MD SECTION 4: MISCELLANEOUS 762 Hematosalpinx Maryam Rezvani, MD

Part VII: Multiorgan Disorders SECTION 1: MALIGNANT NEOPLASMS 766 Genital Lymphoma Douglas Rogers, MD 772 Genital Metastases Douglas Rogers, MD SECTION 2: ABNORMAL SEXUAL DEVELOPMENT 778 Complete Androgen Insensitivity Syndrome Douglas Rogers, MD 780 Ambiguous Genitalia Douglas Rogers, MD 784 Gonadal Dysgenesis Douglas Rogers, MD Part VIII: Pelvic Floor SECTION 1: OVERVIEW 790 Anatomy of the Pelvic Floor Rania Farouk El Sayed, MD, PhD 808 MR Imaging of the Pelvic Floor Rania Farouk El Sayed, MD, PhD SECTION 2: PELVIC FLOOR DYSFUNCTION ANTERIOR COMPARTMENT 814 Anatomy of Bladder and Urethral Support Rania Farouk El Sayed, MD, PhD 832 MR Imaging of Stress Urinary Incontinence Rania Farouk El Sayed, MD, PhD MIDDLE COMPARTMENT 838 Anatomy of Uterocervical and Vaginal Support Rania Farouk El Sayed, MD, PhD 850 MR Imaging of Pelvic Organ Prolapse Rania Farouk El Sayed, MD, PhD POSTERIOR COMPARTMENT 858 Anatomy of Anal Canal and Anal Sphincter Complex Rania Farouk El Sayed, MD, PhD 872 MR Imaging of Fecal Incontinence Rania Farouk El Sayed, MD, PhD 880 MR Imaging of Obstructed Defecation Rania Farouk El Sayed, MD, PhD MULTICOMPARTMENTAL 892 Multicompartmental Imaging Rania Farouk El Sayed, MD, PhD