MR imaging in pelvic inflammatory disease: Comparison with laparoscopy andUS

PURPOSE: To assess the value of magnetic resonance (MR) imaging in the diag nosis of pelvic inflammatory disease (PID) and to compare MR imaging with t ransvaginal ultrasonography (US) and laparoscopy. MATERIALS AND METHODS: Thirty consecutive patients hospitalized because the y were clinically suspected of having PID underwent transvaginal US and T1- weighted spin-echo, T2-weighted turbo spin-echo, and inversion-recovery MR imaging at 1.5 T. All patients underwent laparoscopy after MR imaging. RESULTS: PID was laparoscopically proved in 22 (70%) patients. The MR imagi ng diagnosis agreed with that obtained with laparoscopy in 20 (95%) of the 21 patients with PID. The imaging findings for PID were as follows: fluid-f illed tube, pyosalpinx, tubo-ovarian abscess, or polycystic-like ovaries an d free pelvic fluid. Findings at transvaginal US agreed with those at lapar oscopy in 17 (81%) of the 21 patient; with PID. The sensitivity of MR imagi ng in the diagnosis of PID was 95%, the specificity was 89%, and the overal l accuracy was 93%. For transvaginal US, the corresponding values were 81%, 78%, and 80%. CONCLUSION: MR imaging is more accurate than transvaginal US in the diagnos is of PID and provides information about the differential diagnosis of PID: MR imaging may reduce the need for diagnostic laparoscopy.