Magnetic resonance imaging of uterovaginal lesions associated with female infertility

Objective: To study the mandatory indications and accuracy of magnetic resonance (MR) imaging for the diagnosis of uterovaginal lesions associated with female infertility. Design: Prospective cross sectional study. Main outcome measures: Indications and accuracy of MR imaging for the diagnosis of ut...

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Main Authors: Manal Ezzat Badawy, Dina Gamal Eldeen Y. Elkholi, Mohamed Fouad Sherif, Mohamed Abd Elgeleel Hefedah
Format: Article
Language:English
Published: SpringerOpen 2015-03-01
Series:Middle East Fertility Society Journal
Subjects:
Online Access:http://www.sciencedirect.com/science/article/pii/S1110569014000107
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author Manal Ezzat Badawy
Dina Gamal Eldeen Y. Elkholi
Mohamed Fouad Sherif
Mohamed Abd Elgeleel Hefedah
author_facet Manal Ezzat Badawy
Dina Gamal Eldeen Y. Elkholi
Mohamed Fouad Sherif
Mohamed Abd Elgeleel Hefedah
author_sort Manal Ezzat Badawy
collection DOAJ
description Objective: To study the mandatory indications and accuracy of magnetic resonance (MR) imaging for the diagnosis of uterovaginal lesions associated with female infertility. Design: Prospective cross sectional study. Main outcome measures: Indications and accuracy of MR imaging for the diagnosis of uterovaginal lesions. Materials and methods: 423 infertile women were investigated by hysterosalpingography (HSG) and transvaginal ultrasonography (TVUS). In 54 women having uterovaginal lesions and 76 women with tubo-ovarian lesions, the diagnosis was not conclusive by HSG and TVUS and consequently they were examined by MR imaging. The present study was devoted for infertile women suffering from uterovaginal lesions. Results: MR imaging confirmed the diagnosis of agenesis of the uterus and the vagina (1 case), unicornuate uterus (2 cases, functioning rudimentary horn connected to the dominant horn in 1 case), uterus didelphys (1 case), bicornuate uterus (5 cases), septate and subseptate uteri (10 cases). Eighteen patients had multiple corporeal leiomyomas, 8 subserous and 10 intramural, diffuse adenomyosis, 14 cases and localized adenomyoma, 3 cases. Intramural leiomyomas showed enhancement on T2-weighted imaging suggesting a good response to uterine artery embolization (UAE). The size, number and location of myomas were precisely demonstrated on MR imaging, information necessary for myomectomy and UAE. The findings of MR imaging were compared with the final diagnosis after laparoscopy or surgical intervention and histopathological study. The accuracy, sensitivity, specificity, and positive and negative predictive values of MR imaging for diagnosing uterovaginal lesions associated with infertility were 100%. Conclusion: The present study proved that MR imaging was the method of choice for precise diagnosis of uterovaginal lesions associated with infertility, when the diagnosis was not conclusive on HSG and TVUS. MR imaging was mandatory for conclusive diagnosis of mullerian duct anomalies, adenomyosis uteri and multiple uterine leiomyomas destined to myomectomy or uterine artery embolization. The accuracy, sensitivity, specificity and positive and negative predictive values of MR imaging for diagnosis of these lesions were 100%.
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spelling doaj.art-5d31b158ab234462ac694396ef2188b92022-12-22T01:59:59ZengSpringerOpenMiddle East Fertility Society Journal1110-56902015-03-01201273610.1016/j.mefs.2014.03.001Magnetic resonance imaging of uterovaginal lesions associated with female infertilityManal Ezzat Badawy0Dina Gamal Eldeen Y. Elkholi1Mohamed Fouad Sherif2Mohamed Abd Elgeleel Hefedah3Department of Radio-Diagnosis, Faculty of Medicine, Tanta University, Tanta, EgyptDepartment of Obstetrics and Gynecology, Faculty of Medicine, Tanta University, Tanta, EgyptDepartment of Radio-Diagnosis, Faculty of Medicine, Tanta University, Tanta, EgyptDepartment of Radio-Diagnosis, Faculty of Medicine, Tanta University, Tanta, EgyptObjective: To study the mandatory indications and accuracy of magnetic resonance (MR) imaging for the diagnosis of uterovaginal lesions associated with female infertility. Design: Prospective cross sectional study. Main outcome measures: Indications and accuracy of MR imaging for the diagnosis of uterovaginal lesions. Materials and methods: 423 infertile women were investigated by hysterosalpingography (HSG) and transvaginal ultrasonography (TVUS). In 54 women having uterovaginal lesions and 76 women with tubo-ovarian lesions, the diagnosis was not conclusive by HSG and TVUS and consequently they were examined by MR imaging. The present study was devoted for infertile women suffering from uterovaginal lesions. Results: MR imaging confirmed the diagnosis of agenesis of the uterus and the vagina (1 case), unicornuate uterus (2 cases, functioning rudimentary horn connected to the dominant horn in 1 case), uterus didelphys (1 case), bicornuate uterus (5 cases), septate and subseptate uteri (10 cases). Eighteen patients had multiple corporeal leiomyomas, 8 subserous and 10 intramural, diffuse adenomyosis, 14 cases and localized adenomyoma, 3 cases. Intramural leiomyomas showed enhancement on T2-weighted imaging suggesting a good response to uterine artery embolization (UAE). The size, number and location of myomas were precisely demonstrated on MR imaging, information necessary for myomectomy and UAE. The findings of MR imaging were compared with the final diagnosis after laparoscopy or surgical intervention and histopathological study. The accuracy, sensitivity, specificity, and positive and negative predictive values of MR imaging for diagnosing uterovaginal lesions associated with infertility were 100%. Conclusion: The present study proved that MR imaging was the method of choice for precise diagnosis of uterovaginal lesions associated with infertility, when the diagnosis was not conclusive on HSG and TVUS. MR imaging was mandatory for conclusive diagnosis of mullerian duct anomalies, adenomyosis uteri and multiple uterine leiomyomas destined to myomectomy or uterine artery embolization. The accuracy, sensitivity, specificity and positive and negative predictive values of MR imaging for diagnosis of these lesions were 100%.http://www.sciencedirect.com/science/article/pii/S1110569014000107Infertile womenMR imagingMullerian duct anomaliesLeiomyomasAdenomyosis
spellingShingle Manal Ezzat Badawy
Dina Gamal Eldeen Y. Elkholi
Mohamed Fouad Sherif
Mohamed Abd Elgeleel Hefedah
Magnetic resonance imaging of uterovaginal lesions associated with female infertility
Middle East Fertility Society Journal
Infertile women
MR imaging
Mullerian duct anomalies
Leiomyomas
Adenomyosis
title Magnetic resonance imaging of uterovaginal lesions associated with female infertility
title_full Magnetic resonance imaging of uterovaginal lesions associated with female infertility
title_fullStr Magnetic resonance imaging of uterovaginal lesions associated with female infertility
title_full_unstemmed Magnetic resonance imaging of uterovaginal lesions associated with female infertility
title_short Magnetic resonance imaging of uterovaginal lesions associated with female infertility
title_sort magnetic resonance imaging of uterovaginal lesions associated with female infertility
topic Infertile women
MR imaging
Mullerian duct anomalies
Leiomyomas
Adenomyosis
url http://www.sciencedirect.com/science/article/pii/S1110569014000107
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