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Figure 4.30. The upper vagina mimicking the outer cervical stroma.

(a), (b) Off-axis transaxial T2W1 with a cervical tumour (T) seen in (a) surrounded by a low signal intensity rim (arrows) which was the vagina. More cranially in (b) the tumour can be seen to extend into the parametrium (arrowheads). The left bladder wall is irregularly thickened and of altered signal intensity due to infiltration by a large left pelvic sidewall lymph node metastasis (out of plane on this image).

Figure 4.31. Apperances post radical hysterectomy.

Transaxial (a) and sagital (b) T2W1 demonstrating the oversewn vaginal vault (V), of low signal intensity due to fibrous change, with spread of fibrous tissue to the posterior wall of the bladder (arrow in (b)). The surgical scar is well seen in (b) (arrowheads).

Figure 4.32. Appearances after bilateral pelvic sidewall lymph node dissection.

Transaxial T2W1 showing low signal intensity linear scarring (arrows) extendIng anteroposteriorly along the pelvic sidewalls. There is also high signal intensity ofboth obturator internus muscles (O) due to post-surgical inflammatory change. There is abnormality of the anterior abdominal wall due to oedema at the laparotomy site.

Ovarian Transposition

Figure 4.33. Appearances after bilateral ovarian transposition.

Figure 4.33. Appearances after bilateral ovarian transposition.

Transaxial (a) T1W1 and (b) T2W1 in a patient who underwent ovarian transposition at the time of radical hysterectomy. The ovaries (arrows) have been relocated to the iliac fossae. This procedure is performed to prevent the ovaries being included in a post-operative radiation field and thereby preserve ovarian function. The ovaries should not be confused with tumour masses.

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