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Location of the Uterus and Ovaries (Non-Pregnant Patient)

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Let's begin with the expected location of

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the uterus and ovaries in the female pelvis.

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This is a sagittal, T2-weighted MRI of the

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pelvis, and we can see the uterus here.

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It's interposed between the urinary bladder,

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which is filled with T2-bright urine,

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and the rectum and sacrum posteriorly.

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The uterus is a pear-shaped organ.

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We can see the three distinct

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layers of the uterus.

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We have the endometrium, the

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myometrium, and the junctional zone,

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which is this T2-dark region here.

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The junctional zone is also myometrium.

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It's muscular tissue, but it's more densely

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packed, and there's less water content, which

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is why it looks dark on T2-weighted imaging.

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We can also see the anterior lip of the

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cervix and the posterior lip of the cervix,

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as well as the vagina, which is collapsed.

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We have some T2-bright Nabothian

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cysts within the cervix here.

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I'd like to take a moment to talk about

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version and flexion of the uterus.

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Version refers to the orientation of

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the cervix, and flexion refers to the

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orientation of the uterine fundus.

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And so this patient is slightly anteverted

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and retroflexed in terms of uterine position.

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This is an axial nonfat-saturated T2 image

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of the pelvis where we can again see the

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uterus and those three distinct layers.

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Myometrium, junctional zone, and endometrium.

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We also see the ovaries in this image.

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You will typically see them lateral

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to the uterus along the course

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of the external iliac vessels.

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In patients who have follicles, typically

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premenopausal patients, you'll be able

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to identify the ovaries on MRI and often

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on CT or ultrasound by the follicles,

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which appear T2-bright on MR imaging.

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Thank you.

Report

Faculty

Erin Gomez, MD

Assistant Professor of Radiology

Johns Hopkins Hospital

Tags

Women's Health

Vagina/Vulva

Uterus

Ovaries

MRI

Gynecologic (Gyn)

Gynecologic (GYN)

Genitourinary (GU)

Cervix

Body

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