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*   MR Female Pelvis
*   http://www.radreport.org/template/0000052	


Type: Reporting template
Language: English (en)
Modified date: 2012-07-16
Creator: Jha R
Contributor: Bozkurt S [coder]
Contributor: Kahn CE Jr [editor]
Contributor: International Society for Magnetic Resonance in Medicine (ISMRM)
	
This file is part of the "RSNA Radiology Reporting Templates."

The RSNA Radiology Reporting Templates are licensed without charge under
the RSNA's license agreement (the "License"); you may not use this file
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Unless required by applicable law or agreed to in writing, software
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Copyright (c) 2013, Radiological Society of North America, Inc. (RSNA)
ALL RIGHTS RESERVED

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PROCEDURE:[ Enhanced | Unenhanced ] MRI Pelvis

CLINICAL INDICATION: [Pelvic pain; Suspected pelvic mass]. 

COMPARISON: [<date> | None*].

TECHNIQUE: Pre and [non-dynamic]  [dynamic] post contrast imaging of the pelvis was performed on a [field strength] Tesla scanner. [ ] ml of [name of contrast agent] was administered before and after fat suppressed T1-weighted imaging. Image quality is [satisfactory/degraded by motion/etc].

FINDINGS:

Uterus
	Size: [# x # x # cm]

Configuration: [ Normal | Arcuate | Septate | Bicornuate | Unicornuate |      Didephysis]

Endometrium: [ Normal | Abnormal] The maximum width of the endometrium is []mm.

Junctional Zone: There is [no/mild/moderate/severe] adenomyosis. The maximum Junctional zone thickness is []mm.

	Outer Myometrium: There are [no] leiomyomas.
		Largest Myoma
			Size: [# x # x # cm]
			Location: [ intracavitary| submucosal| intramural| subserosal]  
			Enhancement [present [%], absent]
			Image location: series [#] image [#]

		Second Largest  Myoma
			Size: [# x # x # cm]
			Location: [ intracavitary| submucosal| intramural| subserosal]  
			Enhancement [present [%], absent]
			Image location: series [#] image [#]
		
		Third Largest Myoma
			Size: [# x # x # cm]
			Location: [ intracavitary| submucosal| intramural| subserosal]  
			Enhancement [present [%], absent]
			Image location: series [#] image [#]

	Right Ovary
		Size: [# x # x # cm]
		Image location: series [#] image [#]
	
	Left Ovary
		Size: [# x # x # cm]
		Image location: series [#] image [#]

	Cystic Adnexal  Masses:  [None]
		Number: [ ] 
		Size [of largest cystic mass]: [# x # cm]
Tissue components: [ unilocular | septated | layering debris  | solid nodular components | 
Fluid characteristics: [ | simple | mucin | hemorrhagic | slight protein or hemorrhagic  | macroscopic fat | intravoxel fat and water]
		Location: [Ovary | Fallopian Tube | Parovarian| Peritoneal ]   
		Image location: series [#] image [#]
			
	Cystic and Solid  Adnexal  Mass:  [None]
		Number: [ ] 
		Size [of largest mass]: [# x # cm]
Solid tissue components: [ fibrosis / smooth muscle | papillary projections | non-specific solid tissue  | solid nodular components | 
Fluid characteristics: [ | simple | mucin  |  hemorrhagic | slight protein or hemorrhagic  | macroscopic fat | intravoxel fat and water]
Enhancement pattern of solid components [ homogeneous | heteregeneous| absent ]
		Location:  [Ovary | Fallopian Tube | Parovarian| Peritoneal ]   
		Image location: series [#] image [#]

	Solid  Adnexal  Mass:  [None]
		Number: [ ] 
		Size [of largest mass]: [# x # cm]
Solid tissue components: [ fibrosis / smooth muscle | papillary projections | non-specific solid tissue  | solid nodular components | 
	Enhancement pattern [ homogeneous | heteregeneous| absent ]
		Location:  [Ovary | Fallopian Tube | Parovarian| Peritoneal ]   
		Image location: series [#] image [#]

	
	Cervix: [       ]

	Vagina: [       ]

	Bladder: [       ]

	Lymph nodes: [<Normal size>][<Enlarged; probably reactive>].  

	There is [       ] physiologic pelvic fluid.
      
      There is [   ] ascites. 
      
      There are [  ] peritoneal implants

Impression:[ Enhanced | Unenhanced ] MRI Pelvis