ROLE OF MRI IN EVALUATION OF FEMALE PELVIC MASSES IN COMPARISON TO ULTRASONOGRAPHY

CORRESPONDING AUTHOR:
Dr. Tushar Prabha,
Department of Radiology,
MGMCH, Sitapura,
Jaipur-302022.
Email: dr.sunnygoel@gmail.com
             

ABSTRACT: The study was conducted in 50 female patients having clinically suspected Pelvic masses at physical examination underwent both USG and MRI. Sonographic assessment of uterus, bilateral adnexal regions and pouch of Douglas was done in cases of suspected masses. Other organs such as liver and peritonium were also visualized in cases of malignancies for metastatic lesions. MRI assessment of lesions was done within a short interval of 1-2 days. Most common lesions evaluated on imaging were benign uterine lesions (15 cases, 34.09%), benign adnexal lesions(13 cases, 29.54%), Malignant adnexal (10 cases, 22.73%), Malignant utero cervical lesions (6 cases, 13.64%), 2 cases had indeterminate type lesions, 2 lesions proved to be normal bowel loops on MRI and in 2 cases MRI could not be performed. Cystic lesions were commonly seen in adenexa (15 out 21) while solid lesions were common in utero-cervical region (18 out 23).Out of these 14 were complex cystic adenexal masses and 10 were malignant. Uterocervical lesions were carcinoma cervix. In cases of larger lesions MRI was the best. Both TVS and trans-abdominal USG were less informative in comparison to MRI.  Two cases of dermoid were diagnosed confidently on the MRI because of superior soft tissue contrast and fat detection. Whereas the diagnosis was in doubt on USG. By MRI better assessment with improved imaging capability was possible in invasion of surrounding structure in 10 cases, lymphadenopathy in 3 cases, ascites in 13 cases, peritoneal implant in 6 cases, encasement in 1 case and distant metastases in 1 case. Ascites and metastases were diagnosed in all the patients on USG.  Results indicated higher diagnostic capability of MRI for dermoid, hemorrhagic cyst and pre-treatment assessment of pelvic malignancies; also it is problem solving tool in cases of indeterminate pelvic masses on USG.  MRI is relatively safe, non-operator dependent, has high signal noise ratio and it is an excellent modality for staging pelvic malignancies, it has superior soft tissue contrast and large field of view. All these features offer a distinct advantage of MRI over USG in assessment of female pelvic masses.