Research Of Magnetic Resonance Imaging In Female Pelvic Inflammatory Diseases

PartⅠClinical and MRI features of female Pelvic Inflammatory DiseasesObjective:To study the clinical and MRI features of female pelvic inflammatory diseases.Methods:Seventy two patients with pelvic inflammatory diseases were retrospectively analyzed from Xinhua Hospital from 2008 to February 2016.There were 25 chronic inflammatory diseases（hydrosalpinx）and 47 acute inflammatory diseases（including 21 pyosalpinx,19 tubo-ovarian abscesses,7 pelvic abscesses）.The mean age of these patients was 41.3±10.5 years,ranging from 13 to 59 years.We study the clinical materials,MR images.The ADC values of the masses were measured,whose ROIs were located in the cystic regions.The differences of age,size,wall and/or septa,the ADC values between chronic and acute inflammatory diseases were analyzed.Results:There was no significant difference between chronic and acute inflammatory diseases for age and size.The mean wall and/or septa of patients in acute inflammatory diseases（11.48±6.47mm）was more than that of chronic inflammatory diseases（2.53±1.04mm）.The mean ADC values of acute and chronic inflammatory diseases were（1.07±0.38）×10^-3mm²/s,（2.86±0.20）×10^-3mm²/s,respectively（p<0.001）.There was no significant difference between pyosalpinx,tubo-ovarian abscesses and pelvic abscesses with the mean ADC values of（1.13±0.26）×10^-3mm²/s、（1.05±0.45）×10^-3mm²/s、（1.09±0.36）×10^-3mm²/s,respectively.Conclusion:Pelvic inflammatory diseases are more prevalent in women of reproductive age.The mean wall and/or septa of patients in acute inflammatory diseases is more than that of chronic inflammatory diseases,and the mean ADC value in the cystic regions less than that of chronic inflammatory diseases.The ADC value plays an important role in the diagnosis and classification of PID.Part Ⅱ The Differential Diagnosis Between Complex Pelvic Abscess And Ovarian MalignancyObjective: To distinguish complex pelvic abscess from ovarian malignancy.Material and methods: 28 patients with complex pelvic abscess（with pseudosolids）and 25 patients with ovarian malignancy confirmed by pathology were collected from Xinhua hospital from 2008 to February 2016.All of the patients had proton MR spectroscopy before the surgey.The mean age of the patients were38.9±10.1 years,ranging from 21 to 53 years,and 56.0±15.4 years,ranging from 25 to86 years,respectively.We analyzed the clinical materials and MR images of these patients,and measured the ADC values whose ROIs were located in the cystic and solid regions.The differences of age,size,the ADC values of cystic and solid regions between complex pelvic abscess and ovarian malignancy were analyzed.Results: The 28 patients with complex pelvic abscess were younger than the 25 patients with ovarian malignancy.The mean size of ovarian malignancy was larger than that of complex pelvic abscesses.The mean ADC value of the cystic regions in complex abscess was significantly lower than in malignant tumors（1.05±0.38×10-3mm2/s vs.2.45±0.36×10-3mm2;p < 0.001）.There was difference between complex abscesses and malignant tumors with the mean ADC value of solid regions（1.42±0.18）×10-3mm2/s、（1.21±0.33）×10-3mm2/s,respectively（P﹤0.05）.There was no significant difference between cystic regions of complex abscesses and solid regions of malignant tumors for the mean ADC value.Conclusion:Complex pelvic abscesses mostly occurr in sexually active women of reproductive age,and ovarian malignancy around the menopause.The combination of DWI and conventional MRI is of great value in the differential diagnosis between complex pelvic abscess from ovarian malignancy.