Normal Female Pelvic MRI Report

Normal female pelvic MRI wording must be adapted to age, menopausal status, cycle phase, and clinical question. Endometrial thickness, ovarian volume, and cervical appearance should not be labeled normal or abnormal without that context. A targeted endometriosis or cancer protocol requires more detail than routine pelvic MRI.

This example applies to a diagnostic-quality routine female pelvic MRI. Hysterectomy, oophorectomy, pregnancy, hormonal therapy, and prior pelvic surgery change the template. Remove all enhancement statements when contrast was not administered.

Assessment framework

• Assess uterine position, dimensions, zonal anatomy, and myometrium.
• Measure the endometrium in the appropriate age and hormonal context.
• Review cervical stroma, vagina, and parametrial tissues.
• Assess each ovary separately for morphology, follicles, and focal lesions.
• Check bladder, distal ureters, rectum, pelvic sidewalls, bones, and free fluid.

What the report should contain

• Record the surgical status of the uterus and ovaries correctly.
• Do not label a physiologic follicle or corpus luteum as a pathologic cyst.
• Interpret a small amount of pelvic fluid in clinical context.
• For endometriosis, review anterior and posterior compartments using the targeted protocol.
• Do not call an ovary normal when technical limits prevent its identification.

Common errors

• Interpreting endometrial thickness without menopausal status.
• Calling normal cervical mucus a mass.
• Excluding superficial endometriosis on routine imaging.

Example report wording

Example impression: The uterus is anteverted and normal in size, with preserved myometrial signal and zonal anatomy. Endometrial thickness is appropriate for the clinical context. Cervical stroma is intact. Both ovaries have normal location and morphology, without a suspicious adnexal mass. No pelvic lymphadenopathy, free fluid, or conspicuous deep infiltrating endometriosis is identified.

For an endometriosis indication, also apply the ESUR endometriosis MRI guide.

References

1. American College of Radiology. Practice Parameter for MRI of the Soft-Tissue Components of the Pelvis. Source (opens in a new tab)
2. American College of Radiology. Practice Parameter for CT of the Abdomen and Pelvis. Source (opens in a new tab)

Clinical note: This material is for radiology education. Do not generate an automatic diagnosis or management decision without checking guideline scope, patient factors, and local policy.