Compression of large uterine myoma by sacral promontory: MR findings

We present the MR findings of three cases of large uterine myomas that had geographically nonenhancing areas that were compressed by the sacral promontory. These nonenhancing areas on contrast-enhanced T1-weighted images showed no abnormal signal intensity on T2-weighted images. On delayed images following contrast medium administration, the nonenhancing area eventually enhanced homogeneously. There was no evidence of degeneration at pathologic examination. We think that the sacral promontory may compress large myomas with vascular insufficiency, resulting in delayed contrast enhancement of that area.