Accuracy of magnetic resonance imaging in diagnosis of deeply infiltrating endometriosis

Mohamed Fouad Sherif, Manal Ezzat Badawy, Dina Gamal Eldeen Y. Elkholi
In: The Egyptian Journal of Radiology and Nuclear Medicine · 2014 · vol. 46(1) , pp. 159–165 · doi:10.1016/j.ejrnm.2014.11.009 · W2008166164
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This study found that preoperative magnetic resonance imaging is an excellent tool for accurately mapping multiple pelvic sites of deeply infiltrating endometriosis in patients with suspicious symptoms and examination findings.

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Abstract

To determine the accuracy of MRI and diffusion weighted images in the diagnosis of deep infiltrating endometriosis (DIE). This study included 72 patients (mean age, 28 years; range, 17–41 years). Inclusion criteria were patients who: (a) had a history of symptoms consistent with endometriosis, such as pelvic pain, dysmenorrhea, deep dyspareunia, dyschezia, and infertility; (b) had a pelvic examination revealing thickening of the posterior cul-de-sac and/or nodules; (c) had transvaginal ultrasound showing ovarian cysts with thickened low amplitude echoes. Exclusion criteria were the common contraindications to MRI (pacemaker, metallic foreign bodies, and claustrophobia). MRI was performed using a GE Signa 1.5 T MRI system and no contrast medium was used for imaging. In 70/72 patients, DIE was confirmed at surgery and histopathologic examination. 36/72 (50%) patients had endometriotic nodules infiltrating the rectouterine pouch and rectum, 24/72 (33%) the vesicouterine pouch, 6/72 (8.3%) the urinary bladder and 6/72 (8.3%) the anterior abdominal wall. 20/72 patients (27%) had endometrioma correlating with DIE and another 8/72 (11%) had also adenomyosis. In conclusion, preoperative MRI is an excellent tool to provide a reasonably accurate mapping of multiple sites of pelvic endometriosis with high accuracy.

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Condition tags

endometriosisadenomyosisdie_deep_infiltratingendometriomadysmenorrheadyspareuniainfertility

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