Imaging the Female Pelvis: When Should MRI be Considered?

Jennifer Hubert, MD; Diane Bergin, MD

Disclosures

Appl Radiol. 2008;37(1):9-24. 

In This Article

Abstract and Introduction

Since magnetic resonance imaging (MRI) offers high contrast resolution, provides good tissue characterization, and is capable of multiplanar imaging capabilities, it is becoming a useful tool for the evaluation of female pelvic pathology. Since MRI is more expensive and potentially less readily available than ultrasound, it is important to know when patients should undergo MRI. The authors describe situations in which MRI should be considered to evaluate the female pelvis.

Ultrasound is the imaging modality of choice for the female pelvis. It is widely available, has broad acceptance by patients as a "familiar test," and is relatively inexpensive. High-resolution imaging of transvaginal ultrasound provides high diagnostic accuracy for pelvic pathology. However, there are some shortcomings with this modality, such as the limited feld of view, obscuration of pelvic organs by the presence of bowel gas, inherent limitations dependent on patient size, and its dependence on the skill and experience of the operator. The American College of Radiology has provided guidelines for when ultrasound is an appropriate imaging tool ( Table 1 ) for the evaluation of the female pelvis.[1]

With its high contrast resolution, its ability to provide good tissue characterization, and its multiplanar imaging capabilities, magnetic resonance imaging (MRI) is increasingly used to evaluate pelvic pathology ( Table 2 ).[2,3,4,5] There is a signifcant difference, however, in the inherent costs of MRI and ultrasound. The dilemma for referring physicians and general radiologists is to decide when it is appropriate to refer patients for MRI.[5] This article describes in what situations MRI should be considered to evaluate the female pelvis.

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