Question: MRI Inconclusive. I Have had 2 Ultrasounds and an MRI . I feel constant pelvic pressure, have painful sex. ETC. Please help me understand this MRI. What should my next step be?

Womens Health Center Catskill XXXXXXX Mabry, DO
159 XXXXXXX Heights Suite D203 Catskill, NY 12414-1237 OB - Gynecology
Tel: 518-719-3500 Fax: 518-719-3505
Patient: XXXXXXX Mcgowan
DOB: 02/02/1968
Address: 947 Route 17, , Jewett, NY 12444
Phone: 518-569-5683
Ordered Date: 12/09/2014
Assessments: Hydrosalpinx
Test Name: MRI PELVIS W/WO CONTRAST
Name Value
Radiology Report Exam#: 0000COG
Radiology Report Type/Exam PELVIS WITH+WITHOUT GADOLINIUM
Radiology Report Date of Service: 12/19/2014 01:39 P
Radiology Report Ordering Physician: Mabry, XXXXXXX
Radiology Report
Radiology Report
Radiology Report EXAM: MRI pelvis
Radiology Report
Radiology Report CLINICAL HISTORY: Left adnexal complex mass
Radiology Report
Radiology Report COMPARISON: Pelvic ultrasound 12/01/2014
Radiology Report
Radiology Report TECHNIQUE: Multiaxial multisequence imaging performed before and after
Radiology Report IV administration of 15 ml ProHance gadolinium contrast
Radiology Report
Radiology Report FINDINGS:
Radiology Report
Radiology Report Imaging shows intermediate signal intensity T1 and increased signal
Radiology Report intensity due to structure measuring about 3.8 cm x 1.9 cm by 3.7 cm.
Radiology Report There is a relatively lower intensity due to outer with a single
Radiology Report internal septation towards the lateral one third of the lesion on
Radiology Report coronal images. The T1 and due to signal intensity is greater than
Radiology Report the substance of the uterus on the precontrast images.
Radiology Report
Radiology Report After contrast administration, there is uniform enhancement and the
Radiology Report differentiation between the V1 and T2 component appears to be
Radiology Report abolished. The internal septation is also not seen. On the post
Radiology Report gadolinium images. The entire complex appears to be continuous with
Radiology Report the left coronal region of the uterus.
Radiology Report There are no other abnormally enhancing lesions.
Radiology Report There is no adenopathy in the pelvis.
Radiology Report No significant free fluid is seen.
Radiology Report Tiny hemorrhagic or proteinaceous cyst in the right ovary measuring
Radiology Report about 0.8 cm is seen with low signal intensity on T2 and increased
Radiology Report signal on T1-weighted images.
Radiology Report Visualized bony structures show no evidence of avascular necrosis or
Radiology Report focal lesion.
Radiology Report After gadolinium administration, there is no abnormal enhancement in
Radiology Report the urinary bladder.
Radiology Report Substance of the uterus itself shows uniform expected enhancement.
Radiology Report The junctional zone is thickened and measures 2.1 cm. Adenomyosis is
Radiology Report likely present.
Radiology Report Visualized portions of the GI tract appear unremarkable.
Radiology Report
Radiology Report IMPRESSION:
Radiology Report
Radiology Report Enhancing ovoid somewhat bilobed ( measuring 3.8 x 1.9 x 3.7 cm on the
Radiology Report precontrast images and 4.8 x 3.1 by 2.5 cm on the postcontrast images)
Radiology Report mass in the left adnexa which seems to be of a different imaging
Radiology Report characteristic from the uterus on the precontrast images but shows
Radiology Report uniform increased in T1 signal on the post gadolinium fat suppressed
Radiology Report T1-weighted images. There is also apparent continuity with the left
Radiology Report side of the uterus on the post gadolinium scans. Differential
Radiology Report diagnosis will include an adnexal mass of left ovarian origin versus a
Radiology Report pedunculated fibroid with partial degeneration and blood products. In
Radiology Report the presence of diffuse enhancement, neoplasm is not excluded.
Radiology Report
Radiology Report
Radiology Report Adenomyosis of the uterus.
Radiology Report No evidence of adenopathy or fluid collection.
Radiology Report
Radiology Report
Radiology Report
Radiology Report
Radiology Report
Radiology Report __________________________
Radiology Report
Radiology Report Reported By: Najmus Saqib, MD
Radiology Report
Radiology Report D: 12/19/2014 04:19 P
Radiology Report T: 12/19/2014 04:42 P
Radiology Report Job No:
Radiology Report
Radiology Report
Radiology Report Reported By: - Dr. Najmus Saqib
Radiology Report Signed By: Dr. Najmus Saqib
Radiology Report
Result: neoplasm not excluded
Received Date: 12/19/2014
Notes:

Approved: A0000 @ CMH, valid 12/9-03/09/15 (Med Solutions, Abby)
Ankenman XXXXXXX LPN 12/22/2014 8:58:33 AM >
Mabry XXXXXXX 12/30/2014 2:34:04 PM > see tel enc