MR Female Pelvis

 

View / download

Text    XML

Return to Template view

 

This page demonstrates the templates as a synoptic and hierarchical report, with the initial view showing only the template title and the major section headers of the report. By clicking on the section headers it is possible to drill into the content of the template.

Report
Procedure
MR
Pelvis
Technique
Post contrast imaging
Dynamic
Non-dynamic
Field strength [{decimal} T]
Contrast media
None
Name [ ______ ]
Amount [{decimal} ml]
Image quality
Satisfactory
Degraded by motion [ ______ ]
[ ______ ]
[ ______ ]
Description [ ______ ]
Clinical information
Pelvic pain
None
[ ______ ]
Suspected pelvic mass
None
[ ______ ]
[ ______ ]
Comparison
None [ ______ ]
[ ______ ]
Findings
Uterus
Absent [ ______ ]
Normal [ ______ ]
Endometrial thickness [{decimal} mm]
Configuration
Normal
Arcuate
Septate
Bicornuate
Unicornuate
Didelphys
[ ______ ]
Endometrium
Normal [ ______ ]
Abnormal [ ______ ]
[ ______ ]
Maximum width [{decimal} mm]
Junctional zone [ ______ ]
Adenomyosis
None [ ______ ]
Mild [ ______ ]
Moderate [ ______ ]
Severe [ ______ ]
Maximum thickness [{decimal} mm]
Myometrium [ ______ ]
Leiomyomas [ ______ ]
None
0+ Leiomyoma
positiveInteger
Size
Measurement [{decimal} ]
Measurement [{decimal} ]
Measurement [{decimal} ]
Location
Intracavitary [ ______ ]
Submucosal [ ______ ]
Intramural [ ______ ]
Subserosal [ ______ ]
Exophytic [ ______ ]
[ ______ ]
Enhancement
Present
positiveInteger
"%"
[ ______ ]
Absent
Image location
Series number [{positiveInteger} ]
Image number [{positiveInteger} ]
[ ______ ]
Size
Measurement [{decimal} ]
Measurement [{decimal} ]
Measurement [{decimal} ]
[ ______ ]
Right ovary
Size
Measurement [{decimal} ]
Measurement [{decimal} ]
Measurement [{decimal} ]
Image location
Series number [{positiveInteger} ]
Image number [{positiveInteger} ]
Left ovary
Size
Measurement [{decimal} ]
Measurement [{decimal} ]
Measurement [{decimal} ]
Image location
Series number [{positiveInteger} ]
Image number [{positiveInteger} ]
Adnexal masses
None
Number [{nonNegativeInteger} ]
0+ Adnexal mass
Size
Measurement [{decimal} ]
Measurement [{decimal} ]
Measurement [{decimal} ]
Cystic
Tissue components
Unilocular [ ______ ]
Septated [ ______ ]
Layering debris [ ______ ]
Solid nodular components [ ______ ]
[ ______ ]
Fluid characteristics
Simple [ ______ ]
Mucin [ ______ ]
Hemorrhage [ ______ ]
Slight protein or hemorrhage [ ______ ]
Macroscopic fat [ ______ ]
Intravoxel fat and water [ ______ ]
[ ______ ]
Solid
Components
Fibrosis or smooth muscle [ ______ ]
Papillary projections [ ______ ]
Non-specific solid tissue [ ______ ]
Solid nodules [ ______ ]
[ ______ ]
Enhancement
Homogeneous [ ______ ]
Heterogeneous [ ______ ]
Absent [ ______ ]
[ ______ ]
Location
Right
Left
Ovary
Fallopian tube
Parovarian
Peritoneal
[ ______ ]
Image location
Series number [{positiveInteger} ]
Image number [{positiveInteger} ]
Cervix
Normal [ ______ ]
[ ______ ]
Vagina
Normal [ ______ ]
[ ______ ]
Bladder
Normal [ ______ ]
[ ______ ]
Lymph nodes [ ______ ]
Normal [ ______ ]
Enlarged
Probably reactive [ ______ ]
Abnormal [ ______ ]
Peritoneum
Physiologic pelvic fluid
None
[ ______ ]
Ascites
None [ ______ ]
Mild [ ______ ]
Moderate [ ______ ]
Severe [ ______ ]
Peritoneal implants
None
[ ______ ]
[ ______ ]
Impression
[ ______ ]
Recommendation [ ______ ]