Apport de l’imagerie par résonance magnétique dans la pathologie pelvienne de la femme : à propos de 116 cas

RESUME Objectif. Evaluer la place de l’IRM dans la pathologie pelvienne chez la femme. Population et Methodes. Il s’agissait d’une etude prospective, descriptive, etendue sur 14 mois. Cette etude s’est deroulee dans le service de radiologie et imagerie medicale du centre hospitalier intercommunal Andre Gregoire de Montreuil (France). Chaque patiente incluse avait beneficie de la realisation d’une IRM 1.5 Tesla. Les parametres etudies etaient : l'âge, les indications et les lesions IRM objectivees. Resultats. La frequence des IRM pelviennes etait de 5,1 %. L’âge moyen des patientes etait de 40,9 ans. Les indications des examens d’IRM pelvienne etaient dominees par la recherche d’endometriose (25%), les myomes uterins (19,8%), les douleurs pelviennes (18,1%) et la caracterisation d’une masse annexielle (12,1%). Les lesions uterines (50,9%) etaient les plus observees. Ces lesions uterines etaient dominees par des myomes (37,1%), l’hypertrophie de l’endometre (4,3%) et les malformations (3,4%). La pathologie tumorale maligne uterine n’a ete observee que chez 2 patients. Les lesions ovariennes etaient dominees par le kyste endometriosique (7,8%). On notait 6,9% de cas de tumeur ovarienne. L’endometriose profonde a ete observee chez 3,4% des patients. Conclusion. L’IRM est un outil complementaire indispensable dans l’exploration de la pathologie gynecologique. Elle doit etre realisee apres une echographie. ABSTRACTObjective. To assess the role of MRI in pelvic pathology in women. Population and Methods. This was a prospective, descriptive, 14-month study. This study took place in the radiology and medical imaging department of the Andre Gregoire intercommunal hospital in Montreuil (France). Each patient included had undergone a 1.5 Tesla MRI. The parameters studied were: age, indications and objectified lesions. Results. The frequency of pelvic MRI was 5.1%. The mean age of the patients was 40.9 years. The indications for pelvic MRI examinations were dominated by screening for endometriosis (25%), uterine myomas (19.8%), pelvic pain (18.1%) and characterization of an adnexal mass (12.1%). Uterine lesions (50.9%) were the most observed. These uterine lesions were dominated by myomas (37.1%), endometrial hypertrophy (4.3%) and malformations (3.4%). Malignant uterine tumor pathology was observed in only 2 patients. Ovarian lesions were dominated by the ovarian endometriosis (7.8%). There were 6.9% of cases of ovarian tumor. Deep endometriosis was observed in 3.4% of patients. Conclusion. MRI is an essential complementary tool in the exploration of gynecological pathology. It should be performed after an ultrasound.