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Body of uterus

The body of the uterus is the major, central portion of the uterus located between the fundus above and the isthmus below. It is a thick-walled, muscular organ situated in the female pelvis, posterior to the bladder and anterior to the rectum. The body of uterus plays a critical role in menstruation, implantation, pregnancy, and labor. Its imaging is essential in the diagnosis of gynecologic conditions such as fibroids, adenomyosis, endometrial pathology, and malignancies.

Synonyms

  • Corpus uteri

  • Uterine body

  • Main uterine segment

Location and Structure

  • Lies in the midline pelvis, within the lesser pelvis

  • Normally anteverted and anteflexed over the urinary bladder

  • Extends from the fundus superiorly to the isthmus inferiorly (transition to cervix)

  • Composed of three layers:

    • Endometrium: inner mucosal lining

    • Myometrium: thick muscular layer

    • Perimetrium (serosa): outer covering derived from peritoneum

Relations

  • Anteriorly: Urinary bladder and vesicouterine pouch

  • Posteriorly: Rectum and rectouterine pouch (pouch of Douglas)

  • Laterally: Broad ligament, uterine vessels, and ureters

  • Superiorly: Fundus of uterus, covered by peritoneum

  • Inferiorly: Isthmus, continuous with cervix

Function

  • Houses and nourishes the fertilized ovum during pregnancy

  • Contracts during labor to expel the fetus

  • Plays a role in menstruation through cyclical endometrial changes

  • Provides structural and mechanical support for pelvic viscera

Clinical Significance

  • Common site of leiomyomas (fibroids)

  • Disorders include adenomyosis, endometrial hyperplasia, endometrial carcinoma, congenital anomalies (bicornuate uterus, septate uterus)

  • Enlargement or distortion may cause infertility, pain, or abnormal bleeding

  • Imaging is critical in evaluating infertility, abnormal uterine bleeding, pelvic pain, and malignancy staging

MRI Appearance

T1-weighted images:

  • Myometrium appears low signal intensity

  • Endometrium appears relatively high signal compared to myometrium

  • Fatty tissue and hemorrhage (if present) appear hyperintense

T2-weighted images:

  • Endometrium appears high signal intensity

  • Junctional zone (inner myometrium) appears low signal intensity

  • Outer myometrium appears intermediate signal

  • Pathologies such as fibroids appear as low signal intensity masses

STIR (Short Tau Inversion Recovery):

  • Normal myometrium appears low signal intensity

  • Edema, adenomyosis, or inflammatory changes appear as hyperintense areas

T1 Fat-Sat Post-Contrast:

  • Normal endometrium enhances brightly

  • Myometrium enhances moderately and homogeneously

  • Fibroids may enhance variably (homogeneous, heterogeneous, or rim pattern)

  • Malignancies may show irregular or heterogeneous enhancement

CT Appearance

Non-Contrast CT:

  • Uterine body appears as a soft tissue density structure in the pelvis

  • Endometrium is usually not well differentiated

  • Calcifications may be seen in fibroids

Post-Contrast CT:

  • Myometrium enhances homogeneously in normal uterus

  • Endometrium may be more conspicuous in enhanced scans

  • Fibroids show variable enhancement depending on type and degeneration

  • Malignant lesions show irregular, heterogeneous, or mass-like enhancement

MRI image

body of uterus MRI sagittal image anatomy image-img-00000-00000

CT image

body of uterus CT sagittal image anatomy image-img-00000-00000