Evaluation of MRI’s Role in Characterizing Gynaecological Pelvic Abnormalities

Gynaecological abnormalities of the female pelvis are common and may result from physiological or pathological changes. Ultrasound and computed tomography are often used initially because of their accessibility and cost-effectiveness, but they have limited soft tissue contrast. Magnetic resonance imaging (MRI) offers superior soft tissue resolution, multiplanar capability, and non-invasive assessment without ionizing radiation. It enables accurate detection, staging, and differentiation of pelvic abnormalities, enhancing diagnostic confidence and guiding management. This study aimed to assess the role of MRI in characterizing female pelvic benign and malignant gynaecological conditions. A retrospective study was conducted at Jazan Hospital between July 2024 and June 2025. Ninety-one female patients underwent pelvic MRI, and 63 met the inclusion criteria. Examinations were performed using a 1.5 Tesla MRI scanner with standardized protocols, including T1-weighted, T2-weighted, diffusion-weighted imaging (DWI), and contrast-enhanced sequences. Images were independently reviewed by radiologists, and the findings were categorized as leiomyomas, ovarian cysts, adenomyosis, malignant tumours, or other pelvic pathologies. Data were analysed using SPSS version 27, with the results expressed as frequencies; associations were tested using a chi-square test (p < 0.05). Most patients were aged 36–50 years (69.8%). Most patients were 36–50 years (69.8%). Leiomyomas were the most common finding (63.5%), and adenomyosis (39.7%) followed by ovarian cysts (12.7%). Malignant lesions, including cervical and endometrial carcinomas, were rare (3.2% each). Malignant lesions, including cervical and endometrial carcinomas, were rare (3.2% each). MRI showed a strong ability to differentiate benign lesions from malignant ones, with significant diagnostic correlations for T2-weighted (p < 0.001) and DWI sequences (p < 0.001). MRI is a highly effective tool for evaluating gynaecological pelvic abnormalities. T2-weighted, post-contrast T1 -weighted, and DWI sequences provide valuable information for characterizing gynecological abnormalities, guiding evidence-based clinical management, enhancing lesion assessment, and supporting individualized treatment planning.