Role of ultrasound and MRI in evaluation of pelvic inflammatory disease
European Journal of Molecular & Clinical Medicine,
2022, Volume 9, Issue 9, Pages 309-315
AbstractThe aim of this study is to study Role of ultrasound and MRI in evaluation of pelvic inflammatory disease. Patients with clinically suggested pelvic inflammatory disease who were referred to the Department of Radio Diagnosis are included in this study. After obtaining permission from medical research ethics committee and informed consent from the patients, they were subjected to transvaginal ultrasonography and MRI scan.
Result: Free fluid is most common finding which is seen in 22 patients out of 100 patients. Cervicitis and pyosalpinx were seen in 18 and 17 patients respectively. Tubo-ovarian abscess was finding in 15 patients. Pyometra and hydrosalpinx as findings were seen in 11 patients each. Salpingi-Oophoritis as MRI findings was seen in nine (09) patients. Other findings seen on MRI included: salpingitis (06), endometritis (06), tubal torsion (05), endometrioma (03), free fluid in Pouch of Douglas (03), no gynecological disorder (02), simple cyst (02), peritonitis (02), and dermoid cyst (01) patients respectively. Both TVS and MRI was positive in 80 patients. TVS had findings of pelvic inflammatory disease in four (04) patients with no findings on MRI. The difference was found to be statistically significant (p = 0.00) by using Fisher’s Exact test.
Sensitivity of TVS for diagnosing PID who are truly having it was 91.9% while specificity was 69.2% in ruling out PID in those who didn’t have the disease in question. Similarly, the positive predictive value (PPV) for TVS was 95.2% and negative predictive value (NPV) was 56.2%. Overall, the accuracy of TVS for PID was 89%.
Conclusion: In women of reproductive age, pelvic inflammatory disease (PID) is a prevalent and significant disorder that can cause infertility, ectopic pregnancy, and chronic pelvic pain. Lower abdomen pain, fever, an elevated blood C-reactive protein level, and adnexal tenderness are common symptoms in patients, however the clinical diagnosis of PID has major drawbacks due to the wide range of symptoms and potential for atypical symptoms. PID may mimic gastrointestinal issues, urinary tract infections, and other gynecologic issues. Thus, making a clinical diagnosis of PID based solely on symptoms and physical characteristics is frequently incorrect. The danger of long-term problems rises when treatment is postponed. PID is becoming more common, especially in developing nations where there is a lack of understanding and hazardous sexual behavior.
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