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La radiologia medica

, Volume 117, Issue 4, pp 575–592 | Cite as

Magnetic resonance imaging in women with pelvic pain from gynaecological causes: a pictorial review

  • A. L. ValentiniEmail author
  • B. Gui
  • R. Basilico
  • I. V. Di Molfetta
  • M. Miccò
  • L. Bonomo
Uro-Genital Radiology / Radiologia Uro-Genitale

Abstract

This article illustrates causes of pelvic pain in girls and women that may be inadequately diagnosed by ultrasound (US) and more adequately assessed by magnetic resonance imaging (MRI). We describe MRI features necessary for detecting disease and helpful in differential diagnosis. Special attention is paid to correlating age and pathology by subdividing the population into four categories: girls up to prepubertal age, pubertal girls, women of reproductive age and postmenopausal women. US is the first-line imaging modality in children and women with pelvic pain, and computed tomography (CT) is usually requested, especially in emergency settings, in patients in whom US is inadequate for diagnosis. However, MRI should be considered at least in urgent, if not in emergent, care given the wide range of female pelvic disorders that can be correctly assessed thanks to the excellent soft-tissue contrast, high spatial resolution and ability to depict blood products. Moreover, MRI should be preferred in children and women of reproductive age because of the absence of radiation exposure.

Keywords

Magnetic resonance imaging Female imaging Pelvic pain 

La risonanza magnetica nelle donne con dolore pelvico da cause ginecologiche: pictorial review

Riassunto

Questo articolo illustra le cause del dolore pelvico di natura ginecologica che possono non essere correttamente individuate o che sono dubbie all’ecografia e che appaiono meglio identificabili con risonanza magnetica (RM). Verranno forniti gli elementi di semeiotica RM necessari per la diagnosi e quelli utili per la diagnostica differenziale. Verrà, inoltre, prestata una particolare attenzione nel correlare età e patologia suddividendo la popolazione femminile in 4 categorie: neonate e bambine fino all’età pre-pubere, ragazze al menarca, donne in età fertile e donne in menopausa. L’ecografia è solitamente il primo esame utilizzato nei bambini e nelle donne con dolore pelvico e nei casi dubbi è la tomografia computerizzata ad essere impiegata, in particolare in emergenza. Tuttavia, quando l’ecografia non sia risolutiva bisognerebbe prendere in considerazione la RM, se non in emergenza almeno nei casi di urgenza differibile, in quanto essa è in grado di identificare un ampio spettro di patologie responsabili del dolore pelvico di natura ginecologica grazie alla sua eccellente risoluzione spaziale e di contrasto e alla capacità di identificare i prodotti di degradazione della emoglobina. Non bisogna inoltre dimenticare che la RM dovrebbe essere preferita nei bambini e nelle donne in età riproduttiva a causa dell’assenza di radiazioni ionizzanti.

Parole chiave

Risonanza magnetica Imaging della donna Dolore pelvico 

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Copyright information

© Springer-Verlag Italia 2012

Authors and Affiliations

  • A. L. Valentini
    • 1
    Email author
  • B. Gui
    • 1
  • R. Basilico
    • 2
  • I. V. Di Molfetta
    • 1
  • M. Miccò
    • 1
  • L. Bonomo
    • 1
  1. 1.Section of Radiology, Department of Bioimaging and Radiological SciencesUniversità Cattolica Del Sacro Cuore di RomaRomaItaly
  2. 2.Section of Radiology, Department of Clinical Sciences and BioimagingUniversity “G. D’Annunzio”ChietiItaly

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