MR imaging in the evaluation of female infertility

Magnetic resonance (MR) imaging has proved useful in evaluating various conditions associated with female infertility. With T2-weighted pulse sequences, uterine zonal anatomy can be clearly delineated, and with images obtained in a plane coronal and perpendicular to the long axis of the uterus, the external uterine contour can be evaluated. This latter capability allows the differentiation of a bicornuate uterus from a septate one, a distinction that has not been possible with hysterosalpingography and that enables improved treatment planning. MR imaging accurately demonstrates leiomyomas, providing improved preoperative localization compared with that achievable with hysterosalpingography or ultrasonography, and may be useful in differentiating these tumors from adenomyosis. Endometriosis can be detected with MR imaging, but laparoscopy is more reliable for diagnosis and staging. Although the use of MR imaging is not indicated in every evaluation, the modality is valuable in certain settings, especially those that involve differentiation of congenital anomalies and localization of leiomyomas. In these settings, use of MR imaging can obviate more invasive procedures, such as laparoscopy.