The effectiveness of radiation diagnostics in differentiating the source of pelvic pain in gynecological patients

Abstract

Introduction. Ultrasound (US) diagnostics is used in the diagnosis of chronic pelvic pain (CPP). In difficult cases, magnetic resonance imaging (MRI), computed tomography (CT) with contrast enhancement are used. In modern medicine, there is no standard diagnostic algorithm for СРР and requires development.Aim. To compare the results of ultrasound and MRI for differentiating diagnosis between minor forms of external endometriosis and for studying chronic inflammatory processes in the reproductive tract of women with chronic pelvis pain (CPP).Materials and methods. A total of 183 patients of reproductive age with CPP were included in the examination, of which 95 had CCP associated with external endometriosis, and 88 - with chronic inflammatory diseases of the uterus and appendages not in the acute stage. Prior to initiating therapy, all patients underwent ultrasound and MRI examinations. Statistical analysis of the results was performed using Statistica 10 (StatSoft Inc., USA) and MedCalc (version 15.2) software.Results and discussion. Ultrasound confirmed the presence of endometriosis in 29 (30.52%) women of the main group and in 38 (3.18%) patients of the comparison group. MRI was effective in the main group in 54 examined women (56.84%), in the comparison group - in 41 patients (46.59%). The remaining 12 patients of the main group (12.64%) and 9 women from the comparison group (10.23%) were diagnosed based on laparoscopy performed before the women were included in the study.Conclusions. If early stages of external endometriosis are suspected in patients with СРР, MRI is justified. Differential diagnosis of small forms of external endometriosis and fibrosis associated with inflammation in MRI is difficult. Additional laboratory tests are required for accurate differential diagnosis.