title: MRI in pelvic inflammatory disease: a pictorial review.
abstract: Pelvic inflammatory disease (PID) is an ascending infection of the female genital tract caused by the spread of bacteria from the vagina to the pelvic reproductive organs and occasionally the peritoneum. The most common causative organisms are sexually transmitted. PID is a significant source of morbidity among reproductive age women both as a cause of abdominal pain and as a common cause of infertility. Its clinical presentation is often nonspecific, and the correct diagnosis may first come to light based on the results of imaging studies. MRI is well suited for the evaluation of PID and its complications due to its superior soft tissue contrast and high sensitivity for inflammation. MRI findings in acute PID include cervicitis, endometritis, salpingitis/oophoritis, and inflammation in the pelvic soft tissues. Acute complications include pyosalpinx, tuboovarian abscess, peritonitis, and perihepatitis. Hydrosalpinx, pelvic inclusion cysts and ureteral obstruction may develop as chronic sequela of PID. The pathophysiology, classification, treatment, and prognosis of PID are reviewed, followed by case examples of the appearance of acute and subclinical PID on MR images.
authors.affiliation: Department of Medical Imaging, University of Arizona, 1501 N Campbell Ave., PO Box 245067, Tucson, AZ, 85724, USA. pommersheimf@radiology.arizona.edu.
authors.forename: Ferenc
authors.identifier: 0000-0003-3357-0459
authors.initials: F
authors.lastname: Czeyda-Pommersheim
authors.affiliation: Department of Medical Imaging, University of Arizona, 1501 N Campbell Ave., PO Box 245067, Tucson, AZ, 85724, USA.
authors.forename: Bobby
authors.initials: B
authors.lastname: Kalb
authors.affiliation: Department of Medical Imaging, University of Arizona, 1501 N Campbell Ave., PO Box 245067, Tucson, AZ, 85724, USA.
authors.forename: James
authors.initials: J
authors.lastname: Costello
authors.affiliation: Department of Medical Imaging, University of Arizona, 1501 N Campbell Ave., PO Box 245067, Tucson, AZ, 85724, USA.
authors.forename: Joy
authors.initials: J
authors.lastname: Liau
authors.affiliation: Department of Medical Imaging, University of Arizona, 1501 N Campbell Ave., PO Box 245067, Tucson, AZ, 85724, USA.
authors.forename: Arash
authors.initials: A
authors.lastname: Meshksar
authors.affiliation: Department of Medical Imaging, University of Arizona, 1501 N Campbell Ave., PO Box 245067, Tucson, AZ, 85724, USA.
authors.forename: Hina
authors.initials: H
authors.lastname: Arif Tiwari
authors.affiliation: Department of Medical Imaging, University of Arizona, 1501 N Campbell Ave., PO Box 245067, Tucson, AZ, 85724, USA.
authors.forename: Diego
authors.initials: D
authors.lastname: Martin
mesh_terms: D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging / Q000379:methods*; D000292:Pelvic Inflammatory Disease / Q000000981:diagnostic imaging*
keywords: Endometritis; Fitz-Hugh–Curtis syndrome; Pelvic inflammatory disease; Salpingitis; Tuboovarian abscess