Anatomia Humana

607

The Uterine Cervix on In Vitro and In Vivo MR Images: A Study of Zonal
Anatomy and Vascularity Enveloping Cervical Coil Using an

N.

M.

deSouza1

OBJECTIVE. receiver
from

The purpose

of this study was to characterize
on in vivo and in vitro in early neoplasia.

the normal a normal

zonal anatwith a

I. C. Hawley2
J. E. Schwieso1

omy and vascularity which tointerpret

of the cervix subtle

MR images

obtained

coil surrounding

the cervix. These appearances
changes

provide

data base and coil
axial

D. J. Gilderdale3

w. P. Soufter4

SUBJECTS cytologically
that was

AND METHODS.

normal cervices placed intravaginally and imaging the high-signal

Thirteen women of reproductive were imaged with a ring-design
and envelopedthe cervix. Ti-

age with clinically solenoid receiver
and T2-weighted

images were obtained.
ilarly studied,

Seven uterine specimens
appearances central canal

resected for benign disease were simwith histologic findings. and two stromal zones identified. Unlike the uterine body, they

were correlated

RESULTS.
surrounding

In the in vivo studies,

the endocervical
weremucosa

could be differentiated on both Ti- and T2-weighted images, on which the inner ring had a low signal and the outer ring had an intermediate signal intensity. The outer zone was highly vascularized, with inflow effects from large vessels visible on single-slice
scans. On administration of gadopentetate dimegiumine, the endocervical mucosa

enhanced

rapidly,

whereas

the outerstroma showed

more gradual

enhancement.

The

inner zone enhanced slowly relative to the outer zone. The parametrium was visualized up to 6 cm from the center of the coil, and adjacent colon, fat, and blood vessels were identified. Up to four lymph nodes less than i cm in diameter were seen in the parametrium of three subjects. In the in vitro studies, the endocervical mucosa was of highsignal intensity. in the fibromuscular cervix, an inner low-signal ring correlated with a region of tightly packed stroma (fibroblasts and smooth muscle cells; cell count, 5900 ± 2376 nuclei/mm2) and the intermediate-signal-intensity outer zone corresponded to a

Received February 10, 1994; accepted after revision April 19, 1994.

region of more loosely packed stroma (cell count, 2199 ± 558nuclei/mm2). Retention cysts were present in two multiparous cervices. CONCLUSION. These detailed appearances and enhancement patterns of the normal cervix need to be recognized so that subtle changes in locally invasive cervical neoplasia can be identified.
AJR

Presented
of Magnetic
1 The

at the annual meeting of the Society
Resonance, Dallas, March 1994.

i994;163:607-612

RobertSteiner Magnetic Postgraduate Medical
Du Cane Address of

Resonance School,

Unit,

Royal

HammerW12 OHS, to N. M.

smith Hospital, United Kingdom.

Rd., London correspondence

deSouza.
2Department Histopathology, Kingdom. Elstree Way, BorehamRoyal Post-

graduate
London 3Hirst

Medical School, Hammersmith
W12 OHS, United Centre, Research

Hospital,

wood WD6 1RX, UnitedKingdom.
4

Department

of Obstetrics

and Gynaecology,
HammerKingdom.

Royal Postgraduate Medical School, smith Hospital, London W12 OHS, United

0361-803X/94/1633-0607 © American Roentgen Ray Society

MR imaging of the uterine cervix with a body coil delineates the low-signal inner fibromuscular stromal ring [1-6], but differentiation of the detailed zonal anchitectune seen on in vitrostudies [7] is not possible. The use of an intravaginal coil that envelops the cervix improves the signal-to-noise ratio, which allows thin slices and small fields of view to be used [8]. However, the anatomic features of the cervix on images obtained with this technique have not been described, which may lead to difficulties in interpretation, particularly in subtle or early disease. The punpose...