Abstract
Introduction: Owing to the advanced development of MRI science, it causes obvious great changes of many diseases that affect the female genital system and affect their fertility. Hemorrhagic gynecological diseases especially endometriosis affect young females and cause cyclic pain, in addition to infertility. So early detection is essential for proper treatment. Susceptibility-weighted (SWI) as one of the most recent newly created MRI sequences is highly sensitive to detect products of hemorrhage within different gynecologic disorders with 94.7% sensitivity being more meticulous than conventional MRI sequences as T1 and T2. Aim of the Work: A comparison between T1 and T2 as conventional MRI sequences with susceptibility-weighted images (SWI) in many gynecologic disorders by the detection of the presence of internal products of hemorrhage at any stage. Subjects and Methods: 48 consecutive patients from Benha University clinics (age range, 17 - 60 years; mean age, 35.67 years). The patients included in the study were presenting with pelvic pain, irregular menses, Dyspareunia, and swelling. All with suspicious diagnosis of ovarian and extra-ovarian lesions. 38 patients out of the 48 patients were known to contain hemorrhagic disorder; all the patients underwent MRI routine pelvis protocol adding SWI sequence. Results: There was a greatly significant difference between SWI and conventional MRI sequences T1and T2 with sensitivity 94.7%, 57.9% and 33.3% respectively. Conclusion: SWI is a promising tool in the evaluation of hemorrhagic foci within different gynecological disorders. The great ability of detecting hemosiderin foci increases the value of SWI over conventional MRI or US.
Highlights
Owing to the advanced development of MRI science, it causes obvious great changes of many diseases that affect the female genital system and affect their fertility
Susceptibility-weighted (SWI) as one of the most recent newly created MRI sequences is highly sensitive to detect products of hemorrhage within different gynecologic disorders with 94.7% sensitivity being more meticulous than conventional MRI sequences as T1 and T2
Hemorrhagic gynecological diseases especially endometriosis is of most common causes of infertility that affect young females manifesting primarily as a cyclic pain as well as dysmenorrhea, so its early diagnosis sometimes becomes a challenge and is essential for proper treatment
Summary
Hemorrhagic gynecological diseases especially endometriosis is of most common causes of infertility that affect young females manifesting primarily as a cyclic pain as well as dysmenorrhea, so its early diagnosis sometimes becomes a challenge and is essential for proper treatment. One of the newly created MRI functional sequences is SWI that is greatly able to detect compounds that distort the local magnetic field producing signal void. This property enables SWI to detect hemosiderin, deoxyhemoglobin, calcium, etc. SWI is highly sensitive for detecting products of hemorrhage within various gynecologic pathologies and helpful for the differential diagnosis such as: Gynecological disorders associated with bleeding pathology like: hemorrhagic ovarian cysts, ovarian cancers endometriosis, hemorrhagic uterine pathologies (cancers, adenomyosis with hemorrhagic foci, leiomyomas with red degeneration, with hemorrhagic necrosis, and Placental polyp with hemorrhagic foci) are detected more without the need to do extra sequences like T1-fat sat owing to the great sensitivity and specificity [3]. In the other hand SWI can detect this rim at early phase as signal void due to the blooming effect of deoxyhemoglobin which cannot be done by T1WI [5]
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