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MRI shows defect in endometrial canal, increased T2 signal hyper-density, fluid in fundal portion. Meaning?

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My MRI results: there is a 3cm long oval filling defect in endometrial canal sparing the fundal portion. This shows intermediate increased T2 signal hyper intensity, T1 signal intensity slightly hyper intense to myometrium, and no definite enhancement. There is simple fluid in the fundal portion of the endometrial cavity. Junction all zone is normal in thickness. No evidence of invasion of junction all zone. Could you give me your explanation for this?
Posted Mon, 3 Jun 2013 in Women's Health
Answered by Dr. Timothy Raichle 33 minutes later
Hello, I would be happy to help you with your questions.

Please first begin by explaining to me:
1. What were your symptoms for which you had this imaging done?
2. Did you have an ultrasound?
3. Why did they feel like you needed an MRI?

Thank you!
Above answer was peer-reviewed by
Follow-up: MRI shows defect in endometrial canal, increased T2 signal hyper-density, fluid in fundal portion. Meaning? 2 hours later
Ii went to the doctor initially because I was urinating a couple of times during the night and I wanted to see if there was an issue with my bladder. So I had an ultra-sound done...nothing wrong with my bladder but showed a thickening in my uterus. Waited 6 weeks and had another done...this time I was told my cervix was narrowing so was sent for an MRI...which has prompted this now I am being sent for a biopsy. I still think it is scar tissue where I was knocked by the forceps. I am in no pain, no bleeding.
Answered by Dr. Timothy Raichle 1 hour later
Thank you for the followup information.

Based on what you are telling me, the absolute most likely explanation for the filling defect in the endomtrial lining is a large endometrial polyp. From the MRI, it has a definite structure with a small amount of surrounding fluid. In most cases, polyps of the uterus are associated with spotting unrelated to your cycle, but this is not the rule. Any cancerous changes would definitely have presented with significant abnormal bleeding.

What should be done in someone with your findings includes:
1. You need a biopsy of the inside of the uterus (sounds like this is planned)
2. You possibly need an ultrasound called a sonohysterogram (this is where fluid is pushed into the uterine cavity and would fully define exactly what this is in the uterus)
3. You definitely are going to need (perhaps instead of #2) a hysteroscopy and polypectomy (a procedure in the OR where a camera is put through the cervix and this structure removed)

This is not related to scar tissue from the forceps delivery. It is unlikely to be related to the increased urination at nighttime either (this is probably a separate issue that might be related to incomplete emptying of the bladder). Certainly, forceps delivery with injury to the pelvic floor can be associated with bladder dysfunction and should be discussed as a separate issue.

I hope that this helps. Please ask if you have any followup questions.
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