[Anatomy of the female pelvis on MRI: value of intravaginal contrast].
OBJECTIVE
Prospective monocentric study to determine the feasibility, tolerability and diagnostic value of intravaginal contrast to assess female pelvic anatomy on MRI.


METHODS
Forty-nine consecutive women referred for MRI evaluation of the pelvis, irrespective of the indication, were included in this study. The MR imaging protocol consisted of axial and sagittal T2W images before and after intravaginal instillation of sterile US gel. Eight anatomical regions were analyzed and their visibility graded from 1 to 4 (1=excellent; 4=non-visualized) by 3 radiologists without and with intravaginal gel. The value of intravaginal gel was determined by calculating the difference in the visibility index for each anatomical region by the Wilcoxon and khi2 tests. Inter-observer agreement was also determined using the kappa test.


RESULTS
Two women declined vaginal opacification resulting in an acceptance rate of 96%. The gel instillation procedure had a duration of less than 3 minutes on average and was well tolerated by all patients. Intravaginal gel allowed significantly improved visualization of all anatomical regions (p<0.001); improvement between 0.5 and 2.5 points on average per anatomical region. Inter-observer agreement significantly improved after gel instillation increasing from 72% to 92%.


CONCLUSIONS
Intravaginal instillation of US gel is simple, noninvasive, well-accepted and well-tolerated by patients. It increases visibility of pelvic anatomical structures with improved inter-observer agreement.
Novellas
S
S
Services d'Imagerie Médicale, Centre Hospitalier Régional et Universitaire de Nice, Hôpital Archet 2, 151, route de Saint Antoine de Ginestière, BP 3079, 06202 Nice cedex 3.
Marcotte Bloch
C
C
Berthier
F
F
Fournol
M
M
Delotte
J
J
Bongain
A
A
Chevallier
P
P
D016009:Chi-Square Distribution; D003287:Contrast Media; D003430:Cross-Sectional Studies; D005240:Feasibility Studies; D005260:Female; D005782:Gels / Q000008:administration & dosage; D006801:Humans; D008279:Magnetic Resonance Imaging; D015588:Observer Variation; D010388:Pelvis / Q000033:anatomy & histology*; D011446:Prospective Studies; D018709:Statistics, Nonparametric
D003287:Contrast Media; D005782:Gels