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Masters Thesis | Radiology and Medical Imaging Sciences | India | Volume 14 Issue 5, May 2025 | Popularity: 5 / 10
Role of USG and MRI in Evaluation of Uterine Pathologies at Tertiary Care Center (A Study of 100 Cases)
Dr. Jeet Modi, Dr. Anjana Trivedi, Dr. Manni Sharma, Dr. Vishva Chauhan
Abstract: Introduction: The uterine pathologies constitute one of the most common problems among women. The primary imaging modalities for assessing the female pelvis include Ultrasonography (USG), Magnetic Resonance Imaging (MRI), and Computed Tomography (CT). Ultrasound is typically the first-line imaging tool due to its accessibility, affordability, lack of radiation exposure, and ability to assess vascularity and guide procedures. However, it has limitations, including operator dependency, restricted field of view, difficulty in evaluating parametrial lesions, and challenges in staging malignancy. MRI provides several advantages, including no radiation or iodinated contrast, a greater field of view, superior contrast resolution, multiplanar imaging capabilities, and the ability to distinguish between recurrence, residual disease, and postoperative scarring. As such, MRI plays a vital role in the diagnosis, prognostication, management planning, and follow-up of various pelvic conditions. Materials and methods: Following ethical committee approval and written informed consent from female patients who had suspected uterine lesions, referred from the Gynaecology Department to the Radiology Department at PDU Government Hospital, underwent both Ultrasonography (USG) and Magnetic Resonance Imaging (MRI) to evaluate and correlate various findings of the lesions between October 2023 and March 2025. Eligible participants include patients of all ages with radiologically suspected or diagnosed with uterine pathologies. Exclusion criteria encompass patients with normal imaging outcome, non-willing to give consent or having contraindication to MRI. The study method involves initial evaluation with ultrasonography (transabdominal / transvaginal) followed by MRI evaluation using selected sequences. Contrast and other special sequences like diffusion and gradient imaging were used as and when required. Subsequent comparison of MRI and USG findings for each patient was carried out. Results: Among 100 patients majority of the patients were premenopausal (76%) with majority of them falling under 31-40 years age group (32%) and had lower abdominal pain as most common complaint (53%). Majority of the patients were having benign lesions (82%) with fibroids being the most common etiology (56%). In detection of fibroid USG and MRI were equally effective however, detection of exact number and type of fibroids was better done on MRI. 86 fibroids were detected on MRI and 67 on USG. The most common characteristics of fibroids on USG was hypoechoic echopattern (56%) with peripheral vascularity (60%) while on MRI T1 isointense (45%) and T2 hypointense (54%). MRI correctly diagnosed 16 adenomyotic cases while USG was able to diagnosed adenomyosis only in 10 patients. Both MRI and USG correctly diagnosed every patients with endometrial polyp and cervical cancer. MRI showed 100% sensitivity, specificity, PPV and NPV for fibroids, adenomyosis, endometrial polyp and cervical cancer. Conclusion: USG and MRI shows no significant difference in diagnosing various uterine pathologies. However, for detailed evaluation of lesion like localization, number of lesions, extension of lesions and other characteristics MRI showed upper hand because of its capability of distinguishing the unique characteristics of various lesions with greater accuracy.
Keywords: Fibroids, Adenomyosis, Endometrial Polp, Uterine Pathologies, MRI, USG
Edition: Volume 14 Issue 5, May 2025
Pages: 75 - 89
DOI: https://www.doi.org/10.21275/SR25429193458
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