Utility of Pelvic Magnetic Resonance Imaging in a Younger Population

Pelvic examinations and transvaginal ultrasonography are generally deferred in patients without sexual experience due to potential distress. Transabdominal ultrasonography is widely used but may have variable image quality. Pelvic magnetic resonance imaging (MRI) serves as an alternative to evaluate underlying pathologies. This study investigated the clinical utility of pelvic MRI by comparing clinical presentations and management between adolescents and adults.

In this single-center, retrospective cohort study, we analyzed 262 female patients without sexual experience (63 adolescents, 10-19 years; 199 adults, ≥20 years) who underwent pelvic MRI between 2024 and 2025. MRI was performed to rule out organic disease. Findings were categorized into organic or functional diseases. Post-imaging therapeutic interventions (hormonal therapy, surgery, symptomatic treatment, and referral) were compared between groups.

Abnormal MRI findings were observed in 87.4% of the cohort. Functional diseases predominated in adolescents (49.2% vs. 34.7%, p<0.001), whereas organic diseases were more prevalent in adults (76.4% vs. 33.3%, p<0.001). The therapeutic intervention rate was significantly higher in adolescents (74.6% vs. 49.2%, p<0.001). Hormonal therapy was the primary treatment in both groups, exceeding 60% in each. However, symptomatic treatment was more frequent in adolescents, whereas surgery was more common in adults (both p<0.05).

Gynecological care for this population must address distinct age-specific clinical profiles. Adolescent organic disease prevalence is higher than expected, with hormonal intervention rates equivalent to adults. In community practice, pelvic MRI effectively guides management to optimize comprehensive women's health.