Date : 00.00.00
Name of the Patient : Abc XyzN. Goslmn / F / 48 yrs.
Referred by : Dr. Abc Xyzlal.
Examination : M.R.I. of the Pelvis.
CLINICAL PROFILE :
H/O vaginal hysterectomy done 16 years back. Detected to have vaginal squamous cell carcinoma 6 months back. Received radiotherapy.
Now C/O vaginal discharge, burning micturition and abdominal pain.
M.R.I of the pelvis was performed using the following parameters:
10 mm thick T1 Weighted and T2 Weighted (with fat saturation) axial images.
8 mm thick T1 Weighted and T2 Weighted (with fat saturation) sagittal images.
7 mm thick T1 Weighted coronal images.
The body of the uterus is not identified, the result of previous surgery.
The vagina is seen to be bulky and shows hyperintense signal on the T2 Weighted images (isointense to normal muscle on the T1 Weighted images). The vaginal lumen is compressed and shifted to the left side. The vaginal stump also shows similar signal characteristics. The fat planes between the vagina and the urinary bladder and rectum are lost. There is no extension of this lesion into the ischio-rectal fossa bilaterally.
The wall of the urinary bladder is markedly thickened and may be the result of previous radiotherapy. Hyperintense signal seen within the soft tissues on the T2 Weighted images around the vagina may represent post-radiotherapy changes. There is also extension into the soft tissues just below the skin surface.
There are no abnormally enlarged pelvic lymph nodes identified. Subcentimetre lymph nodes are visualized in the inguinal region bilaterally. No obvious vascular anomaly is noted. A small amount of free fluid is identified anterior to the sacrum.
In a known C/O squamous cell carcinoma of the vagina, the MRI features are suggestive of a mass lesion involving the vagina as described. There is no obvious extension of this mass lesion into the parametrium or ischio-rectal fossae. However the fat planes between the vagina and the urinary bladder and rectum are lost.