MRI is it complementary or mandatory to ultrasound in classification of different congenital anomalies of female reproductive tract?

Aim of work: To assess the added value of MRI compared to US in diagnosis of Mullerian duct anomalies and its subtypes thus guiding proper management plans. Patients and methods: From October 2014 to March 2015 we prospectively evaluated 50 female patients, ranging in age from 15 to 40 years. They were referred for US and MRI assessment of clinically suspected Mullerian duct anomalies. Results: Final diagnosis of patients includes: 8/50 (16%) cases were classified as class I, 10/50 (20%) cases were classified as class II, 22/50 (44%) cases were classified as class III, 5/50 (10%) cases were classified as class IV and 5/50 (10%) cases were not MDA. MRI was superior to US, with reported diagnostic accuracy of 100%. Conclusion: The use of diverse imaging modalities, in conjunction with clinical information, provided important clues to the diagnosis of MDAs. The imaging work-up for MDAs usually begins with ultrasound. Although it might have been suffice to detect the presence of a uterine abnormality, MRI was generally needed to classify the abnormality into a specific MDA category

Placenta previa; MRI as an adjunct to ultrasound in assessment of suspected placental invasion

Objective: Evaluate adding MRI to ultrasound in imaging of placenta previa with suspected placenta accreta. Patients and methods: evaluation of 23 pregnant females presenting with placenta previa was done. The age ranged from 20 to 39 years (mean = 30.9). All of the patients were subjected to ultrasonography (US) and magnetic resonance imaging (MRI) of the pelvis at gestational age of 25–37 weeks prior to elective delivery. Results: 11 out of 23 patients were proved placenta accreta based on surgical and pathological reports. US suggested diagnosis of placenta previa/accreta in 8 patients and placenta previa without accreta in 15 cases. 7/8 was true positive (87.5%) & one was false positive (12.5%) with sensitivity 63.64%, accuracy 78.26%, and specificity 91.67%. MRI has suggested diagnosis of placenta previa/accreta in 8/23 & placenta previa with no accreta in 15/23 patients. MRI was found to give true positive results in 8/8 patients proved to be accreta. MRI gave true negative in 12 patients (80%) & false negative in 3 (20%) with sensitivity 72.73%, accuracy 86.96%, and specificity 100%. Conclusion: Combining MRI and ultra sound provide more diagnostic information and may reduce unnecessary interventions with favorable outcome. Keywords: Ultra sound, MRI, Placenta previa, Placenta accret