Women’s Pelvic Imaging

Charter Radiology is at the forefront of women’s pelvic health imaging, providing precise diagnoses of complex pelvic conditions including uterine fibroids, pelvic congestion syndrome, and adenomyosis. Working with referring physicians and OB/GYNs, Charter’s state-of-the-art imaging studies confirms the diagnosis of these often painful conditions, helping physicians provide targeted treatments to help alleviate patients’ painful symptoms.

Pelvic MRI provides good tissue characterization, is capable of multi-planar imaging capabilities, has become a useful tool for the evaluation of female/male pelvic pathology.

With the use of the 3T MR scanner, Charter Radiology offers high resolution images that will assist in the diagnosis and treatment plans for a number of pelvic pathologies.


  • Simple cyst
  • Dermoid
  • Endometriosis
  • Adenomyosis (focal and diffuse)
  • Fibroids
  • Hydrosalpinx
  • Detection and staging of gynecologic malignancies
  • Evaluation of pelvic pain or mass
  • ID congenital anomalies
  • Pre-op evaluation
  • Cervical and endometrial carcinoma staging

Uterine Fibroids

Uterine fibroids are benign (non-cancerous) tumors that grow in the wall of the uterus. According to womenshealth.gov, about 20 to 80 percent of women develop fibroids by the time they reach age 50. Fibroids are most common in women in their 40s and early 50s. Not all fibroids cause symptoms, but women who do have symptomatic fibroids typically experience some pain and heavy menstrual bleeding.

While some uterine fibroids can be diagnosed during a pelvic exam, many patients are referred to Charter Radiology for additional imaging studies to confirm the exact size and location of the fibroids, and if there are multiple fibroids present.

Imaging studies performed include:

  • MRI: Charter Radiology’s 3 Tesla Vida MRI technology has the most powerful MRI magnet to provide extraordinarily clear images. The images provide the exact location of the fibroid which helps determine the treatment – whether the patient chooses myomectomy, uterine artery embolization to shrink the fibroids, or hysterectomy.
  • CT scan: Our low-dose 128-slice CT technology takes high-resolution x-ray images of the uterus and surrounding structures from various angles to provide a more comprehensive look at the fibroid structure.
  • Ultrasound: Using sound waves (instead of x-rays) to produce an image, we can see the uterine fibroid’s size and location within the uterus.

WATCH: Diagnosing Uterine Fibroids with MRI

Pelvic Congestion Syndrome and Adenomyosis – Painful, Difficult to Diagnose Conditions in Women

Diagnosing Pelvic Congestion Syndrome

For many women who suffer from chronic pelvic pain, pelvic congestion syndrome (PCS) is one of the common diagnoses. Difficult to diagnose, pelvic congestion syndrome affects the lower pelvic area and can cause pain and discomfort for weeks and months. The condition is thought to be caused by enlarged veins and/or faulty valves in the veins of the pelvis, similar to varicose veins that can appear in the legs. Women of childbearing age who have had one or more pregnancies are typically at higher risk for developing this condition.

Charter Radiology’s diagnostic imaging studies combine advanced ultrasound technology with powerful 3T MRI. Ultrasound can identify the faulty valves and reflux in the ovarian veins. MRI, used in tandem with ultrasound, provides advanced visualization of the abnormal pelvic veins, clearly identifying any abnormalities while also evaluating the surrounding pelvic structures.

Case Study: Pelvic Congestion Syndrome with Rare Venous Complication

In this case, a young female presented to Charter Radiology with chronic pelvic pain. A pelvic ultrasound revealed a normal appearance of the uterus and ovaries but enlarged pelvic veins compatible with pelvic congestion syndrome. MRI demonstrated enlarged pelvic veins around the uterus but also showed thrombus within the enlarged left ovarian vein, a rare complication.


Another painful condition that can affect some 20% to 65% of women aged 35 to 50 years, adenomyosis is a condition that causes the uterus to thicken and enlarge. Endometrial tissue that lines the uterine wall grows into the outer muscular wall of the uterus, causing the uterus to enlarge and leading to painful, heavy menstrual bleeding.

At Charter Radiology, we accurately diagnose this condition using pelvic ultrasound and 3T MRI, which show uterine enlargement and thickening of the endometrial tissue. Women usually present with abnormal bleeding, pain, and even infertility.

Adenomyosis Case Study:

This case shows diffuse thickening of the junctional zone. The dark band in the video is only seen on MRI and not on ultrasound. Adenomyosis can only be excluded on MRI.

Imaging for Uterine Anomalies

Uterine anomalies such as uterus didelphys (double uterus) and septate uterus (a membrane down the middle of the uterus splits the organ into two parts) are very rare issues that can typically only be diagnosed by imaging studies such as ultrasound and MRI. Septate uterus versus a bicornuate uterus (an irregularly shaped uterus) can only be differentiated on MRI.

Uterus Didelphys

Septate Uterus

Septate Uterus

Ovarian Carcinoma – Information Coming Soon.

At Charter Radiology, our focus is on providing the most compassionate care and comprehensive diagnostic imaging studies for patients living with these chronic pelvic conditions using only the most advanced imaging technology. Call today to schedule an appointment with one of our specialists – 443-917-2855.