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MRI in pelvic inflammatory disease: a pictorial review

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Abstract

Pelvic inflammatory disease (PID) is an ascending infection of the female genital tract caused by the spread of bacteria from the vagina to the pelvic reproductive organs and occasionally the peritoneum. The most common causative organisms are sexually transmitted. PID is a significant source of morbidity among reproductive age women both as a cause of abdominal pain and as a common cause of infertility. Its clinical presentation is often nonspecific, and the correct diagnosis may first come to light based on the results of imaging studies. MRI is well suited for the evaluation of PID and its complications due to its superior soft tissue contrast and high sensitivity for inflammation. MRI findings in acute PID include cervicitis, endometritis, salpingitis/oophoritis, and inflammation in the pelvic soft tissues. Acute complications include pyosalpinx, tuboovarian abscess, peritonitis, and perihepatitis. Hydrosalpinx, pelvic inclusion cysts and ureteral obstruction may develop as chronic sequela of PID. The pathophysiology, classification, treatment, and prognosis of PID are reviewed, followed by case examples of the appearance of acute and subclinical PID on MR images.

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Authors and Affiliations

  1. Department of Medical Imaging, University of Arizona, 1501 N Campbell Ave., PO Box 245067, Tucson, AZ, 85724, USA

    Ferenc Czeyda-Pommersheim, Bobby Kalb, James Costello, Joy Liau, Arash Meshksar, Hina Arif Tiwari & Diego Martin

Authors
  1. Ferenc Czeyda-Pommersheim
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  2. Bobby Kalb
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  3. James Costello
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  4. Joy Liau
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  5. Arash Meshksar
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  6. Hina Arif Tiwari
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  7. Diego Martin
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Corresponding author

Correspondence to Ferenc Czeyda-Pommersheim.

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No funding was received for this study.

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The authors declare that they have no conflict of interest.

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This study does not contain any studies with animals performed by any of the authors. All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

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Informed consent was obtained from all individual participants included in the study.

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CME activity This article has been selected as the CME activity for the current month. Please visit https://ce.mayo.edu/node/34273 and follow the instructions to complete this CME activity.

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Czeyda-Pommersheim, F., Kalb, B., Costello, J. et al. MRI in pelvic inflammatory disease: a pictorial review. Abdom Radiol 42, 935–950 (2017). https://doi.org/10.1007/s00261-016-1004-4

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  • DOI: https://doi.org/10.1007/s00261-016-1004-4

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