Utility of MRI in uterine and adnexal lesions

Abstract

Objective:To ascertain the role of MRI as a problem solving modality in characterising indeterminate uterine and adnexal masses from USG.Methods:A prospective study was conducted with100 female patients with pelvic pathologies who underwent an ultrasound examination and proved to be diagnostic dilemmas.These patients were further investigated with an MRI of the pelvis without contrast. Routine sequences were performed in all patients including T1Wi ,T2Wi and GRE.Results:There were 70 uterine lesions (fibroids -39, adenomyosis -14,Mullerian anomalies – 4,bulkiness of uterus -8,low lying placenta antenatal scan -2) and 30 adnexal lesions(malignant ovarian cysts -10,dermoid cyst – 6,chocolate cyst -8,tubovarian masses – 6,chronic torsion -1,chronic ectopic – 1,peritoneal inclusion cyst -1).The diagnosis made after the MRI scan was compared to the working diagnosis made from USG and these were separately compared with the HPR diagnoses in 53 patients who underwent surgery. The remaining 43 patients who were treated conservatively the MRI diagnoses were compared with the working USG diagnoses.The statistical data was analysed bycontingency coefficient, CC, method (variant of Chi square method).The CC for USG diagnoses and postoperative diagnoses was statistically significant.The CC for MRI diagnoses and postoperative diagnoses was 0.684 at a p value of 0.013.Conclusions:The analysis of data from the study indicates a strong association between the MRI diagnoses and the postoperative diagnoses, more so than the USG diagnoses and the postoperative diagnoses. There is more variability between the USG diagnoses and the postoperative diagnoses by comparison.