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Limited-sequence MRI clarifies murky pelvic ultrasound findings. (Benefits 97% of Cases).

CHICAGO -- In the majority of patients with indeterminant pelvic findings on ultrasound, limited-sequence MR imaging provides an optimal way to guide clinical management without incurring the costs of a full MRI examination, Dr. Silvia Chang said at the annual meeting of the Radiological Society of North America.

Limited-sequence MRI of the pelvis is a quick, 20-minute exam that focuses on the axial plane for adnexal lesions and the sagittal plane for endometrial lesions, an approach that is especially helpful for stretching MRI resources when access is limited, explained Dr. Chang of Vancouver (B.C.) Hospital.

In what is believed to be the first study of its -kind, 100 patients aged 17-82 years underwent limited-sequence MRI to gain further information about indeterminant pelvic ultrasound findings at the hospital from 1997 to 2001. Exams were performed both transabdominally and transvaginally, All diagnoses wire confirmed either by surgical pathology or by clinical and radiologic follow-up.

Overall, limited-sequence MRI was beneficial in 97% of cases. It increased diagnostic confidence in 32% of cases and provided additional information to establish the diagnosis and guide clinical management in 65% of cases.

Even in the most experienced hands, ultrasound can yield indeterminant findings in 1% of cases. In this study the majority of the indeterminant ultrasound findings fell into two categories: pelvic masses or endometrial abnormalities.

Among those with pelvic masses, the majority turned out to be uterine leiomyomas, most of which had a typical low-signal appearance. In such cases, MRI helps to depict the normal endometrium as a high signal to identify the uterus and then shows the bridging or cross lines to confirm that a mass arises from the uterus.

Of the 23 patients with endometrial abnormalities, most abnormalities were determined on MRI to be either endometrial polyps or submucosal leiomyomas.
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Author:Demott, Kathryn
Publication:OB GYN News
Date:Feb 1, 2002
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