MR appearance

Layered anatomy of the vagina can be recognised on MR imaging. Mucous secretions within the lumen and the inner mucosal layer may be seen as low signal on T1W1 and high signal on T2W1. The surrounding layer of submucosa, collagen, and longitudinal and circular smooth muscle have low signal on T1W1 and T2W1. The surrounding adventitia that contains the vaginal venous plexus appears of high signal intensity on T2W1 (Figures 3.17 and 3.18).

Following intravenous Gd-DTPA the vaginal muscle wall and submucosa enhance. A central low signal intensity line, which probably represents the vaginal lumen, is occasionally identified (Figures 3.6 and 3.1). The vaginal appearances vary with the phase of the menstrual cycle. The wall thickness is thicker in the proliferative phase than the secretory phase. Vaginal secretions are most prominent in the late proliferative and early to mid secretory phase. In the postmenopausal woman, the vaginal wall is thin and of low signal intensity on T1 and T2W1.

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