Adnexal Masses Caused by Pelvic Inflammatory Disease: MR Appearance

Purpose: To describe the morphologic and signal intensity characteristics of inflammatory adnexal masses in magnetic resonance (MR) images.

Materials And Methods: MR images of 15 patients with a total of 20 confirmed inflammatory adnexal masses were analyzed retrospectively.

Results: The findings obtained from MR imaging were as follows: lesions have ill-defined borders; ill-defined areas of high intensity signals surround the masses on T(2)-weighted images; a "rim" at the innermost layer of the cyst wall exhibits high signal intensity on T(1)-weighted images and low intensity on T(2)-weighted images; secondary changes in the surrounding fat plane and bowel loops are extensive; and adhesions are dense. These findings reflect the basic characteristics of the inflammatory process, which are edema caused by increased permeability and highly vascularized granulation tissue caused by the strong tendency to repair.

Conclusion: MR imaging findings well reflect the basic pathological process of inflammation, and inflammatory adnexal masses are associated with relatively specific appearances in MR images. MR imaging can be a problem-solving alternative in the diagnosis of inflammatory adnexal masses.