Acute pelvic pain in female with ruptured ectopic pregnancy: Magnetic Resonance Imaging as problem solving tool

A 31 year old female was referred to our Magnetic Resonance Imaging (MRI) department with history of lower abdominal pain for three days. The patient had a history of irregular periods, with no definite period of amenorrhea. There was no history of bleeding per vagina. The ultrasound performed by the referring physician showed a complex right adnexal lesion abutting the uterus with no free fluid in the pelvis, prompting the physician to think of a broad ligament fibroid. Subsequently the patient tested mildly positive for urine gravindex. As the physician felt that ultrasound was not contributing to a proper diagnosis, MRI pelvis was requested to help solve the clinical problem. Blood sample was given for assessment of Serum human chorionic gonadotropin (beta hCG) level at this same time. MRI images are shown as Figs. 1e4.