Comparative study between MRI and Ultrasound in evaluation of Uterine lesions

Background: Uterine pathologies, including adenomyosis, uterine leiomyoma, carcinoma of the uterus, and endometrial lesions, represent some of the most common gynecological conditions. Magnetic Resonance Imaging and Ultrasonography are crucial diagnostic tools in assessing these lesions, but their diagnostic accuracy and reliability vary. This study aimed to compare the diagnostic accuracy of MRI and USG in assessing uterine lesions, with histopathology as the gold standard. Methods: Fifty female patients of reproductive age with suspected uterine lesions were included. All patients underwent both USG and MRI, followed by histopathological evaluation. Sensitivity, specificity, and accuracy were calculated for each modality in diagnosing different uterine lesions. Results: The mean age of the participants was 46.7 ± 7.0 years. The most common presenting symptoms were bleeding (72%) and pelvi-abdominal pain (26%). USG identified endometrial hyperplasia in 34%, myoma in 28%, adenomyosis in 16%, polyp in 12%, carcinoma in 8%, and no detectable abnormalities in 2% of cases. MRI identified myoma in 32%, adenomyosis in 24%, polyp in 18%, endometrial hyperplasia in 18%, and carcinoma in 8%. finally histopathological diagnosis showed myoma in 30%, adenomyosis in 24%, polyp in 18%, endometrial hyperplasia in 16%, and carcinoma in 12%. The sensitivity of USG was 75%, with a specificity of 95% and accuracy of 91%, while MRI had a sensitivity of 83%, specificity of 95%, and accuracy of 91% in diagnosing uterine masses, particularly in differentiating malignancy. Conclusion: Both MRI and USG are effective in diagnosing uterine masses; however, MRI demonstrates superior sensitivity, particularly in detecting malignancy.