Is pelvic MRI a necessary complementary examination to ultrasound?

Adnexal masses are frequently detected by ultrasound and pose diagnostic problems, because sometimes benign and malignant characteristics overlap. MRI is preferred as a second imaging method for the evaluation of an insufficiently defined adnexal mass, in order to provide the best care. Magnetic resonance imaging allows more accurate and complete diagnosis and staging than ultrasound, especially in cases of deep pelvic endometriosis. In addition, MRI can identify implants at sites difficult to access by laparoscopy. The first-line examination of pelvic venous insufficiency, frequent in multiparous women, is ultrasound and Doppler, but MRI, which is less invasive than venography, allows even a 3D study of pelvic varicose veins. In assessing the pelvic diaphragm, ultrasound and MRI are comparable and demonstrate a moderate value. Non-visualization of ovaries by ultrasound and magnetic resonance-guided focused ultrasound in the non-invasive treatment of uterine fibromas represent other situations that prove the increasingly frequent need to associate pelvic MRI with ultrasound. [ABSTRACT FROM AUTHOR]