MRI PELVIS: CAN IT BE A PROBLEM SOLVING TOOL IN IMAGING OF FEMALE INFERTILITY?
European Journal of Molecular & Clinical Medicine,
2022, Volume 9, Issue 3, Pages 11463-11474
Abstract
Background: Female infertility is quite prevalent these days and with development of newer treatment options, Magnetic Resonance Imaging (MRI) is frequently performed where diagnosis is arduous. The aim of our research was to study the indications of MRI pelvis and its accuracy with respect to hysteroscopy/laparoscopy in evaluation of female infertility and to aid in determination of cases requiring interventional or surgical correction.A retrospective cross sectional study was carried out for two years eight months between March2019 and November 2021. Amongst 183 infertile women(with primary and secondary infertility) of age group 19-40 years were evaluated, 82 patients who were not conclusively diagnosed by Ultrasonography (USG) or Hysterosalpingography (HSG) were referred for MRI.The MRI findings were compared with hysteroscopic/laparoscopic findings which were considered final. Data was analyzed for indications of MRI and its diagnostic accuracy in female infertility.
Results: On MRI, we found 27 cases of Mullerian anomalies, 16 cases of leiomyoma(Multiple/submucosal), 12 cases of adenomyosis , 11 cases of infective etiology [pelvic inflammatory disease (PID) / pyosalpinx/ hydrosalpinx], 9 cases of endometriosis, 3 cases of endometrial polyp, 3 cases of uterine synechiae. MRI was able to correctly diagnose 78 out of 82 cases. Our MRI findings were confirmed with hysteroscopy or laparoscopy. In majority of cases, MRI findings were same as the surgical findings. Only in few(n=3)cases, findings onMRI were discordant with final surgical diagnosis.
Conclusion: Our study shows that MR imaging is highly accurate noninvasive method of choice for diagnosis of uterovaginal & tubo-ovarian lesions associated with female infertility, especially where the diagnosis is controversial on USG and HSG. Its diagnostic accuracy approaches that of hysteroscopic/ laparoscopic findings in 96.2% of the cases. The superior soft tissue resolution and multiplanar capability of MRI helps in better delineation of the morphology and orientation of pelvic structures. Hence MRI plays a decisive role in management of female infertility and can come to rescue in complex cases.
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