Magnetic resonance imaging patterns of premenopausal gynaecological conditions among women at Muhimbili National Hospital

Abstract

BACKGROUND: Gynecological conditions are common among premenopausal women and significantly affect fertility, quality of life, and productivity. Magnetic Resonance Imaging (MRI) offers superior soft tissue characterization compared to other modalities but local data on MRI patterns in Sub-Saharan Africa remain limited. OBJECTIVE: To determine the MRI patterns of gynecological conditions among premenopausal women at Muhimbili National Hospital (MNH), Dar es Salaam, Tanzania. MATERIALS AND METHODS: A prospective descriptive cross-sectional study was conducted from July to December 2022 among 100 premenopausal women aged 18-45 years referred for pelvic MRI. Data on socio-demographic, clinical, and imaging findings were analyzed using SPSS version 20. Associations were assessed using chi-square and logistic regression, with significance set at p < 0.05. RESULTS: The majority of participants (80%) were aged above 30 years, and 51% were nulliparous. The prevalence of gynecological conditions was 82%, with uterine fibroids being the most common (37%), followed by simple ovarian cysts (8%) and ovarian tumors (7%). Lower abdominal pain (65%) was the most frequent symptom. Women aged ≥30 years (OR=10.4, 95% CI: 2.5-43.1, p = 0.001) and nulliparous women (OR=5.2, 95% CI: 1.9-13.6, p = 0.001) were significantly more likely to have fibroids, while parity was protective against other gynecological tumors (OR=0.3, 95% CI: 0.1-0.9, p = 0.03). MRI demonstrated characteristic lesion patterns aiding differentiation between benign and malignant lesions. CONCLUSION: Gynecological conditions are highly prevalent among premenopausal women, with fibroids being the leading diagnosis. MRI plays a key role in their detection and characterization. Advancing age and nulliparity are significant predictors of fibroids, while parity appears protective against other tumors. RECOMMENDATIONS: Further multi-center studies incorporating histopathological correlation and longitudinal follow-up are recommended to strengthen diagnostic accuracy and clinical applicability.