Accuracy of magnetic resonance imaging for diagnosis and preoperative assessment of deeply infiltrating endometriosis

Chamié, Luciana Pardini; Blasbalg, Roberto; Gonçalves, Maynara Santana; Carvalho, Filomena Marino; Abrão, Maurício Simões; Oliveira, Ilka S. de

doi:10.1016/j.ijgo.2009.04.013

Cited by 103 publications

(63 citation statements)

References 17 publications

(35 reference statements)

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“…Imaging techniques that are currently used to evaluate and assess DIE include ultrasonography (US) and magnetic resonance imaging (MRI). Although transvaginal US is considered to be the primary imaging modality for diagnosis of endometriosis, the role of MRI in patients with pelvic pain symptoms has been expanding steadily over the past years (5)(6)(7)(8). Currently, the state-of-the-art imaging protocol for the evaluation of endometriosis includes T2-and fat suppressed T1-weighted sequences in various different imaging planes (7)(8)(9).…”

Section: Deep Infiltrating Pelvic Endometriosis (Die)mentioning

confidence: 99%

Magnetic resonance imaging in the evaluation of (deep infiltrating) endometriosis: The value of diffusion‐weighted imaging

Busard

Mijatovic

Kuijk

et al. 2010

Magnetic Resonance Imaging

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Purpose: To assess the value of magnetic resonance (MR) diffusion-weighted imaging (DWI) in the evaluation of deep infiltrating endometriosis (DIE). Materials and Methods:In a prospective single-center study, DWI was added to the standard MRI protocol in 56 consecutive patients with known or suspected endometriosis. Endometriotic lesions as well as (functional) ovarian cysts were analyzed for location, size, and signal intensity on T1, T2, and DWI. Apparent diffusion coefficient (ADC) values were calculated using b-values of 50, 400, 800, and 1200 s/mm 2 . Statistical analysis included the Spearman correlation coefficient, Mann-Whitney U, and Kruskal-Wallis tests.Results: A total of 112 lesions (62 endometrial cysts and 48 DIE) were detected, 60 of which were large enough to analyze. Mean ADC values of endometrial cysts and functional ovarian cysts were 1.11 Â 10 Conclusion: Results of our study suggest that ADC values of DIE are consistently low, without significant difference between pelvic locations.

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Section: Deep Infiltrating Pelvic Endometriosis (Die)mentioning

confidence: 99%

Magnetic resonance imaging in the evaluation of (deep infiltrating) endometriosis: The value of diffusion‐weighted imaging

Busard

Mijatovic

Kuijk

et al. 2010

Magnetic Resonance Imaging

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“…MRI represents an accurate method for the detection of adenomyosis, sensitivity, and specificity varying from 86 % to 100 % [5,14,[18][19][20][21][22], making this a highly effective tool for the diagnosis of this disease [14].…”

Section: Introductionmentioning

confidence: 99%

Patients with adenomyosis are more likely to have deep endometriosis

et al. 2012

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This study seeks to analyze the association between adenomyosis diagnosed by magnetic resonance imaging (MRI) and endometriosis. This is a prospective study of consecutive patients. One hundred fifty-two patients with histologically confirmed endometriosis. Patients were submitted to MRI, then divided into Group A (with adenomyosis) and Group B (without adenomyosis). Thickness of the junctional zone and the presence of intramyometrial cysts were the principal criteria for diagnosis of adenomyosis. MRI data were correlated with clinical status, staging, sites affected, and histological classification of endometriosis. The prevalence of adenomyosis in endometriosis patients was 42.76 %. Patients with endometriosis and adenomyosis were more likely than those without adenomyosis to report severe or incapacitating dysmenorrhea (61.53 % in Group A; 44.83 % in Group B; p00.041) and deep dyspareunia (64.61 % in Group A; 41.38 % in Group B; p00.005), to have stage IV endometriosis (50.77 % in Group A; 33.34 % in Group B; p00.03), to have endometriosis of the rectosigmoid (49.23 % in Group A; 32.18 % in Group B; p00.033), and to have undifferentiated or mixed histological types of endometriosis (52.31 % in Group A; 34.48 % in Group B; p00.028). A correlation was found between adenomyosis and deep endometriosis with poorer prognosis, particularly endometriosis of the rectosigmoid.

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“…Literatūros šaltinių duomenimis, MRT yra reikšmingas tyrimo metodas nustatant GIE ir vertinant proceso išplitimą [18,19]. Tai iš dalies patvirtina ir mūsų gauti rezultatai, nors tyrimo imtis buvo nedidelė.…”

Section: Rezultatų Aptarimasunclassified

“…Tai iš dalies patvirtina ir mūsų gauti rezultatai, nors tyrimo imtis buvo nedidelė. Kai kurių autorių buvo pastebė-ta, kad makštį bei tiesiąją žarną užpildžius vandens pagrindu pagamintu ultragarso geliu, gaunami geresni rezultatai negu standartinio MRT metu [13,18,19]. Literatūros šaltiniuo-se aprašoma keletas klinikinių tyrimų, kuriuose nurodomi konvencinės ir modifikuotos MRT diagnostinės vertės parametrai (jautrumas, specifiškumas, TPV, NPV, tikslumas), vertinant endometriozės židinius [13,[18][19][20][21].…”

Section: Rezultatų Aptarimasunclassified

“…Apžvelgę mūsų ir ankstesnių atliktų panašių tyrimų rezultatus matome, kad makštį ir tiesiąją žarną užpildžius ultragarso geliu, endometriozės židiniai randami daug lengviau, todėl padidėja MRT tyrimo diagnostinės vertės parametrai [9,13,[18][19][20][21]. Ši tyrimo metodika yra paprasta, neskausminga, nebrangi, specialios įrangos ar personalo paruošimo nereikalaujanti bei gana gerai pacienčių toleruojama procedūra, turėtų būti atliekama visoms pacientėms, kurioms kliniškai įtariama GIE [13].…”

Section: Rezultatų Aptarimasunclassified

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Magnetinio Rezonanso Tomografijos Reikšmė Diagnozuojant Endometriozę

Gudžiūnienė

Atstupėnaitė

Basevičius

et al. 2015

Medicinos Teorija Ir Praktika

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SANTRAUKAReikšminiai žodžiai: endometriozė, magnetinio rezonanso tomografija (MRT), ultragarso gelis. Darbo tikslas. Nustatyti MRT reikšmę diagnozuojant endometriozę. Tyrimo medžiaga ir metodai. Tyrime dalyvavo pacientės (n = 39), kurioms 2012 metais Lietuvos sveikatos mokslų universiteto ligoninėje Kauno klinikose buvo atlikti dubens organų MRT tyrimai dėl įtariamos giliosios endometriozės. Kontrolinės grupės (n = 28) pacientėms MRT tyrimai buvo atlikti pagal įprastinę metodiką. Tiriamosios grupės (n = 11) pacientėms MRT tyrimai buvo atlikti makštį ir tiesiąją žarną užpildžius ultragarso geliu. Rezultatai. Endometriozės židiniai MRT tyrimu aptikti 82 proc. pacienčių, iš jų 90,9 proc. tiriamojoje ir 78,6 proc. kontrolinėje grupėse. Vertinant giliosios endometriozės židinius, MRT tyrimo jautrumas -100 proc. tiriamojoje ir 91,3 proc. kontrolinėje grupėse, specifiškumas -atitinkamai 50 proc. ir 80 proc., teigiama prognostinė vertė (TPV) -atitinkamai 90 proc. ir 95,4 proc., neigiama prognostinė vertė (NPV) -atitinkamai 100 proc. ir 66,7 proc., tikslumas -atitinkamai 90,9 proc. ir 89,2 proc. Išvados. Tiriant giliosios endometriozės židinius, konvencinė MRT pasižymėjo dideliu jautrumu, specifiškumu, TPV ir tikslumu bei vidutiniška NPV. Užpildžius makštį bei tiesiąją žarną vandens pagrindu pagamintu ultragarso geliu, MRT tyrimas pasižymėjo didesniu jautrumu, NPV ir tikslumu, tačiau mažesniu specifiškumu ir TPV negu konvencinė MRT. MRT tyrimu daugiausia endometriozės židinių buvo rasta užpakalinėje gimdos sienelėje ir kiaušidėse. Tiriamojoje ir kontrolinėje grupėse rezultatai iš esmės nesiskyrė. ABSTRACT Key words: endometriosis, magnetic resonance imaging (MRI), ultrasonographic gel.Objective. To identify the significance of MRI in the diagnostics of endometriosis. Materials and methods. This study included 39 women who had MRI for deep pelvic endometriosis in the Hospital of Lithuanian University of Health Sciences Kaunas Clinics in 2012. 28 women in control group had standart MRI. 11 women in study group had MRI after intra-vaginal and intra-rectal opacification with ultrasonographic gel. Results. Endometriotic lessions were found in 82 % of patients (90.9 % in study group and 78.6 % in control group). The sensitivity of MRI for detection of deep endometriotic lessions was 100 % in study group and 91.3 % in control group, the specificity -50 % and 80 %, positive predictive value (PPV) -90 % and 95.4 %, negative predictive value (NPV) -100 % and 66.7 %, accuracy -90.9 % and 89.2 %. Conclusions. Conventional MRI is characterized by high sensitivity, specificity, PPV and accuracy as well as moderate NPV in the investigation of deep endometriosis. MRI after intra-vaginal and intra-rectal gel opacification has a higher sensitivity, NPV and accuracy, but lower specificity and PPV than conventional MRI. In our study the most common sites for endometriotic lesions were posterior wall of the uterus and ovaries. The results did not differ significantly in study and control groups. Eglė Gudžiūnienė Lietuvos sveikatos mokslų uni...

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Accuracy of magnetic resonance imaging for diagnosis and preoperative assessment of deeply infiltrating endometriosis

Abstract: MRI demonstrates high accuracy in diagnosing DIE in the retrocervical region, rectosigmoid, bladder, ureters, and vagina.

Cited by 103 publications

References 17 publications

Magnetic resonance imaging in the evaluation of (deep infiltrating) endometriosis: The value of diffusion‐weighted imaging

Magnetic resonance imaging in the evaluation of (deep infiltrating) endometriosis: The value of diffusion‐weighted imaging

Patients with adenomyosis are more likely to have deep endometriosis

Magnetinio Rezonanso Tomografijos Reikšmė Diagnozuojant Endometriozę

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