CRITICAL SOFT-TISSUES OF THE FEMALE PELVIS - SERIAL MR-IMAGING BEFORE, DURING, AND AFTER RADIATION-THERAPY

PURPOSE: To evaluate the findings in the irradiated critical soft-tiss ue organs of the female pelvis at magnetic resonance (MR) imaging with in 30 months after radiation therapy. MATERIALS AND METHODS: Twenty-th ree patients (13 premenopausal and 10 postmenopausal women) with advan ced cervical carcinoma underwent 276 MR examinations (T1- and T2-weigh ted imaging) scheduled before, three times during, and 7 weeks and 3, 6, 9, 12, 18, 24, and 30 months after the end of radiation therapy. A visual evaluation of the ureters, bladder, rectum, parametrium, and pe rivesical and perirectal soft tissues was performed by two radiologist s. RESULTS: Fifteen abnormally wide ureters (diameter range, 7-23 mm; mean diameter, 14 mm) were seen in 10 (seven premenopausal and three p ostmenopausal women) (43%) of 23 patients at a median time of 18 month s after the end of radiation therapy (range, 9-30 months). An abnormal ly wide ureter was a transient finding in eight (53%) of 15 abnormal u reters. Two premenopausal women (9%) of 23 patients had rectovaginal f istulas. One of these two patients also had a vesicovaginal fistula. C ONCLUSION: Ureteral dilatation was seen in nearly half of the patients and occurred more frequently in premenopausal women than in postmenop ausal women. Knowledge about the appearances of radiation-induced abno rmalities of the critical soft tissues may be of help in the interpret ation of MR images of the pelvis.