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Year :2019
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Month :
March-April
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Volume :
8
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Issue :
2
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Page :
RO28 - RO32
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Role of Magnetic Resonance Imaging in Evaluation of Uterine Pathologies and its Correlation with Ultrasound
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Correspondence Address :
Muthuswamy Prabakaran Shiva Shankar, Swaminathan Ram Kumar, Taj Dhar, Kallupalayam Natesan Venkateshwaran, Ramraj Balaji,
Dr. Swaminathan Ram Kumar,
Department of Radiodiagnosis, SRM Medical College Hospital and Research Centre, Kattankulathur, Kancheepuram,
Tamil Nadu, India.
E-mail: shivashankarmp@gmail.com
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Introduction: Introduction: The uterine pathologies constitute one of the most common problems among women. The most common of them are adenomyosis, uterine leiomyoma, carcinoma of uterus and cervix and endometrial pathologies including polyp and hyperplasia. Magnetic Resonance Imaging (MRI) and Ultrasound (USG) appears to be important modalities in diagnosing uterine pathologies. Considering the cost and limited availability, physicians and the general radiologists are mostly in a dilemma in finding out the appropriate patients needing a MRI.
Aim: To compare MRI and USG in detection of uterine lesions and also in differentiation and characterization of uterine lesions.
Materials and Methods: A prospective study was done on 92 patients who were referred to radiology department of SRM medical college with suspected uterine pathologies. All patients who had positive or suspicious USG findings were subjected to MRI examination. The uterine pathologies were broadly classified into four categories namely fibroid, adenomyosis, endometrial pathologies including endometrial carcinoma and cervical malignancies. The comparison was made between two modalities for detection and characterization of each of pathologies with histopathology as gold standard. The statistical parameters including sensitivity, specificity, positive and negative predictive value were calculated for both the modalities in all pathologies with chi-square test.
Results: Among 92 patients, majority were diagnosed as fibroids 44 (48%), carcinoma of cervix 20 (22%), adenomyosis 16 (17%) and endometrial lesions 12 (13%). A total of 24 (26%) patients were found to be malignant whereas 68 (74 %) patients were found to be benign. There was significant difference in diagnosing adenomyosis by MRI compared to USG (chi-sq=32, p=0.0001) where MRI diagnosed all 16 patients compared to six patients in USG. MRI was better than USG in detection of number of fibroids. Ninety six fibroids were detected by MRI where as only 68 fibroids were detected by USG and the detection rate was more with smaller and submucosal fibroids. Similarly, MRI was better than USG in diagnosis of cervical carcinoma. MRI had diagnosed all 20 cases (chi-sq=32, p=0.0001) where USG diagnosed only 10 cases (chi-sq=0.85, p=0.358). Among 12 endometrial lesions MRI had diagnosed 10 lesions correctly (chi-sq=17.21, p=0.0001) where USG had diagnosed eight lesions correctly (chi-sq=6.97, p=0.008).
Conclusion: To localize, characterize, and evaluate the number of uterine lesions both benign and malignant along with its staging in pelvic pathologies, MRI was found to be more precise and gold standard in comparison to USG most of the times. MRI had an edge over USG in detecting endometrial invasion in case of endometrial carcinoma and staging in case of carcinoma cervix.
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