Magnetic resonance imaging in obstetrics and gynecology: progress and limitations

Abstract

The introduction of phase-array coils, fast spin echo, and certain other pulse sequences together with use of contrast agents has refined the application of magnetic resonance imaging (MRI) in pelvic disease. It makes management decisions in a number of benign conditions including uterine anomalies, adenomyosis, and leiomyomas of the uterus and endometriosis, especially in the context of infertility; it facilitates identification and characterisation of adnexal masses. In uterine malignancy, the multiplanar capability and excellent soft tissue contrast permit accurate assessment of depth of tumor invasion, tumor volume, and extension to adjacent structures. Its precise role in the management of primary and recurrent ovarian cancer remains to be decided. In pelvic malignancy, contrast facilitates identification of viable tumor but does not improve tissue specificity. In obstetrics, MRI is an attractive alternative to X-ray pelvimetry and assists in the evaluation of associated uterine and pelvic pathology. The use of echo-planar imaging eliminates movement artifact and has the potential to complement ultrasound in the assessment of fetal abnormalities and provide a method of identifying growth retardation from volume measurements of body organs.