Diagnostic Value of Magnetic Resonance Imaging in Gynaecology

EDITORIAL COMMENT: We accepted this paper for publication because we thought readers would be interested to know of the diagnostic accuracy of magnetic resonance imaging in gynaecology. It should not be overlooked that patients with a palpable mass in the pelvis almost always need a laparotomy once the general condition has been assessed and chest radiography performed to exclude multiple metastases i.e. in most cases investigations do not alter management. This statement applies to ultrasonography, radiography and magnetic resonance imaging. Often it is wise to do a barium enema in a patient with a pelvic mass mainly to establish whether the condition is a general surgical or a gynaecological problem but the fact of the matter is masses do not go away without surgery and deferring of surgery by investigation is not helpful to the patient's prognosis. Summary: In this study 23 patients with various gynaecological pathologies were evaluated. Ultrasonography and magnetic resonance imaging were performed in all cases, but only 14 were evaluated with computed tomography. On the basis of ultrasonography, 4 patients were labelled as having malignant ovarian tumours, however, this diagnosis was confirmed by magnetic resonance imaging in only 1 of the 4. Magnetic resonance imaging also determined the correct diagnosis in a patient with endometrioma whereas computed tomography showed only a simple cyst, and ultrasonography diagnosed a subserous myoma. Tumour was demonstrated by magnetic resonance imaging in 2 patients with cervical carcinoma although computed tomography and ultrasonography had previously shown no tumour mass in these patients. It was concluded that magnetic resonance imaging is much superior to computed tomography and ultrasonography in gynaecological diagnosis. This advantage results from the correct detection of the contents of ovarian cysts, the number and localization of uterine leiomyomas in T2 scans, invasion of uterine malignancies and differential diagnosis of subserous uterine leiomyomas from ovarian tumours.