Application of the #Enzian classification for endometriosis on MRI: prospective evaluation of inter- and intraobserver agreement

Harth, Sebastian; Kaya, Hasan Emin; Zeppernick, Felix; Meinhold-Heerlein, Ivo; Keckstein, Jörg; Yildiz, Selcuk Murat; Nurkan, Emina; Krombach, Gabriele Anja; Roller, Fritz Christian

doi:10.3389/fmed.2023.1303593

Cited by 5 publications

(1 citation statement)

References 31 publications

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“…Both classifications have their strengths and weaknesses, but both of them have a common end point of classifying endometriosis. The use of ENZIAN has been very useful for both surgical approaches and diagnostics and aims to enable documentation of surgical findings, ultrasound, and MRI clearly and objectively [ 164 ].…”

Section: Management and Treatment In Current Clinical Practicementioning

confidence: 99%

The Known, the Unknown and the Future of the Pathophysiology of Endometriosis

Ochoa Bernal,

Fazleabas

2024

IJMS

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Endometriosis is one of the most common causes of chronic pelvic pain and infertility, affecting 10% of women of reproductive age. A delay of up to 9 years is estimated between the onset of symptoms and the diagnosis of endometriosis. Endometriosis is currently defined as the presence of endometrial epithelial and stromal cells at ectopic sites; however, advances in research on endometriosis have some authors believing that endometriosis should be re-defined as “a fibrotic condition in which endometrial stroma and epithelium can be identified”. There are several theories on the etiology of the disease, but the origin of endometriosis remains unclear. This review addresses the role of microRNAs (miRNAs), which are naturally occurring post-transcriptional regulatory molecules, in endometriotic lesion development, the inflammatory environment within the peritoneal cavity, including the role that cytokines play during the development of the disease, and how animal models have helped in our understanding of the pathology of this enigmatic disease.

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Section: Management and Treatment In Current Clinical Practicementioning

confidence: 99%

The Known, the Unknown and the Future of the Pathophysiology of Endometriosis

Ochoa Bernal,

Fazleabas

2024

IJMS

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Anogenital distance on MRI does not correlate to surgical diagnosis of endometriosis in patients without prior abdominal surgery

Harth,

Metze,

Leufkens

et al. 2024

Sci Rep

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Anogenital distance (AGD) is regarded as a potential biomarker for endometriosis, and a measurement on MRI images has been found to be promising. This study aimed to evaluate the measurement of AGD on MRI to predict the surgical diagnosis of endometriosis. We included 127 patients who received an MRI for endometriosis between October 2018 and February 2023. AGD was measured on MRI by two readers (MRI-AGD-AC: clitoris to anus; MRI-AGD-AF: posterior fourchette to anus). The feasibility and interobserver reliability of AGD measurements were evaluated. Differences in AGD between patient groups were analyzed. The intraclass correlation coefficient estimates indicated a good to excellent reliability of MRI-AGD-AC (0.92; 95% CI: 0.83–0.95) and a poor to good reliability of MRI-AGD-AF (0.68; 95% CI: 0.27–0.83). No statistically significant differences in the mean MRI-AGD-AC and MRI-AGD-AF in patients with and without surgical diagnosis of DIE (p = 0.413; p = 0.110), peritoneal endometriosis with and without DIE (p = 0.641; p = 0.323), and ovarian endometriosis (p = 0.155; p = 0.150) were found. The AUC ranged from 0.475 (95% CI: 0.365–0.584) to 0.586 (95% CI: 0.454–0.718). Thus, AGD does not constitute a valuable biomarker for patients with clinically suspected endometriosis.

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Incidental findings on MRI for the evaluation of endometriosis: prevalence and clinical significance

Harth,

Roller,

Brose

et al. 2024

Front. Med.

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ObjectivesThis study aimed to analyze the prevalence and clinical significance of incidental findings on MRI for endometriosis. Differences between patients with and without evidence of deep infiltrating endometriosis on MRI were to be examined.MethodsThis was a retrospective, descriptive cross-sectional single-center study. All patients who received a pelvic MRI for endometriosis between April 2021 and February 2023 were included. The presence and frequency of incidental findings were noted after review of all MR images and radiology reports. The potential clinical significance of the findings was analyzed. Differences in the frequency of incidental findings between patients with and without evidence of deep infiltrating endometriosis on MRI were evaluated, utilizing the Chi-square test, Fisher's exact test and Mann–Whitney U-test.Results303 consecutive patients (mean age, 33.4 years ± 8.3) were evaluated. Incidental findings were noted in 299/303 (98.7%) patients. Most frequently, ossification of the hip acetabular rim and degenerative changes of the lumbar spine were noted. In 25/303 (8.3%) patients, incidental findings had high clinical significance. For specific incidental findings, significantly higher prevalences were found in patients with than in patients without evidence of deep infiltrating endometriosis on MRI (hip acetabular rim ossification, p = 0.041; annulus fibrosus fissures, p = 0.006; gallstones, p = 0.042).ConclusionsIncidental findings are very common on pelvic MRI for endometriosis. The detection of incidental findings can lead to the diagnosis of relevant diseases and thus enable early treatment. On the other hand, many incidental findings have no, only minor, or uncertain consequences.

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Application of the #Enzian classification for endometriosis on MRI: prospective evaluation of inter- and intraobserver agreement

Cited by 5 publications

References 31 publications

The Known, the Unknown and the Future of the Pathophysiology of Endometriosis

The Known, the Unknown and the Future of the Pathophysiology of Endometriosis

Anogenital distance on MRI does not correlate to surgical diagnosis of endometriosis in patients without prior abdominal surgery

Incidental findings on MRI for the evaluation of endometriosis: prevalence and clinical significance

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