Evaluation of Gynecological Mass Lesions Using Magnetic Resonance Imaging: An Observational Study

Gynecological masses in females comprise benign and malignant masses. These lesions have become a great concern for gynecologists and radiologists because the pelvic organs are aligned in such proximity that any masses arising from these organs may share similar signs and symptoms. Though ultrasonography is the first preference to investigate these masses, it has limited value because of its poor acoustic windows, poor depth of penetration, and operator dependency. Computed tomography is devoid of soft tissue contrast and becomes more complex when discriminating pelvic lesions from decompressed loops of intestine. However, MRI has been found to be more useful than other imaging modalities because it provides better contrast resolution, which facilitates precise tissue characterization and enhanced anatomical depiction; therefore, it is more specific and accurate than ultrasonography and computed tomography for diagnosing gynecological masses.

This retrospective study was conducted in the Department of Radiodiagnosis at Hi-Tech Medical College and Hospital, Rourkela, Odisha, after obtaining approval from the Institutional Ethics Committee. After optimizing the minimal sample size, a total of 106 cases were selected for this study during the period of February 2024 to July 2025. Patients who underwent MR imaging of the pelvis on the advice of the referring gynecologist after suspicion of a gynecological mass were included in this study.

Out of 106 cases, 69 (65.09%) were neoplasms, and 37 (34.91%) were non-neoplastic lesions. Among the neoplasms, 52 (49.06%) were benign masses and 17 (16.04%) were malignant masses. Among benign masses, fibroids were identified in 31 cases (29.24%), and benign ovarian tumors in 21 cases (19.81%). Of the malignant lesions, nine (8.49%) were cervical carcinomas, seven (6.6%) were endometrial carcinomas, and one was an ovarian epithelial carcinoma. Among the non-neoplastic lesions, the incidence of endometriosis at 19 (17.92%) was the highest. It was followed by seven cases of adenomyosis (6.6%). Other non-neoplastic masses were ovarian cysts, endometrial polyps, hematocolpos, and retained products of conception.

MRI is the sole imaging technique that effectively assesses gynecological masses and addresses radiological challenges. Its non-invasive nature renders it preferable for patients, particularly when ethical concerns arise regarding histopathological evaluations. Additionally, MRI aids in the characterization, classification, and future management of gynecological masses.