MRI in pelvic inflammatory disease: a pictorial review

Area of Science:

• Radiology
• Gynecology
• Infectious Diseases

Background:

• Pelvic inflammatory disease (PID) is a significant cause of morbidity in reproductive-age women, leading to abdominal pain and infertility.
• PID is an ascending infection of the female genital tract, commonly caused by sexually transmitted bacteria.
• Clinical presentation of PID is often nonspecific, necessitating advanced imaging for diagnosis.

Purpose of the Study:

• To review the pathophysiology, classification, treatment, and prognosis of PID.
• To illustrate the appearance of acute and subclinical PID on Magnetic Resonance (MR) images.
• To highlight MRI's role in evaluating PID and its complications.

Main Methods:

• Review of existing literature on PID and its imaging characteristics.
• Analysis of MRI findings associated with acute PID, including cervicitis, endometritis, and salpingitis/oophoritis.
• Identification of chronic sequelae of PID on MR imaging, such as hydrosalpinx and pelvic inclusion cysts.

Main Results:

• MRI demonstrates superior soft tissue contrast and high sensitivity for inflammation in PID evaluation.
• Acute PID findings include inflammation of pelvic reproductive organs and surrounding soft tissues.
• Complications such as tuboovarian abscesses and perihepatitis are identifiable via MRI.
• Chronic sequelae like hydrosalpinx and ureteral obstruction can be visualized.

Conclusions:

• MRI is a valuable tool for diagnosing PID and its acute and chronic complications.
• Understanding MRI findings is crucial for accurate diagnosis and management of PID.
• This review provides a comprehensive overview of PID imaging on MRI, aiding clinicians and radiologists.