Endometriosis: Contribution of 3.0-T Pelvic MR Imaging in Preoperative Assessment—Initial Results

Hottat, Nathalie; Larrousse, C.; Anaf, Vincent; Noël, Jean‐Christophe; Matos, Celso; Absil, Julie; Metens, Thierry

doi:10.1148/radiol.2531082113

Cited by 120 publications

(91 citation statements)

References 28 publications

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“…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). This provides consistent information on the extent, severity, as well as the stage of hemorrhagic components of endometriosis, especially in DIE.…”

Section: Deep Infiltrating Pelvic Endometriosis (Die)mentioning

confidence: 99%

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

Busard¹,

Mijatovic²,

Kuijk³

et al. 2010

Magnetic Resonance Imaging

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Section: Deep Infiltrating Pelvic Endometriosis (Die)mentioning

confidence: 99%

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

Busard¹,

Mijatovic²,

Kuijk³

et al. 2010

Magnetic Resonance Imaging

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“…It presents a high specificity in diagnosing endometriomas (98%) [25], owing to its ability to characterise haemorrhage. 'Shading' is a specific sign of endometrioma; it is caused by old blood products, which contain extremely high iron and protein concentrations.…”

Section: Endometriomamentioning

confidence: 99%

“…Pelvic 3T MRI guarantees a high spatial and contrast resolution, providing accurate information about endometriosis implants and a good pre-surgical mapping of lesions involving bowels, serosal surface of the bladder, and the utero-sacral ligaments [25,62]. Manganaro et al [62] reported 3T MRI mean sensitivity, specificity, positive predictive value and negative predictive value of 93%, 75%, 93%, 75%, respectively, in diagnosing DIE of the posterior compartment.…”

Section: Deep Infiltrating Endometriosis Of the Posterior-lateral Commentioning

confidence: 99%

Imaging for the evaluation of endometriosis and adenomyosis

Exacoustòs

Manganaro

Zupi

2014

Best Practice & Research Clinical Obstetrics & Gynaecol

211

143

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Endometriosis affects between 5 and 45% of women in reproductive age, is associated with significant morbidity, and constitutes a major public health concern. The correct diagnosis is fundamental in defining the best treatment strategy for endometriosis. Therefore, non-invasive methods are required to obtain accurate diagnoses of the location and extent of endometriotic lesions. Transvaginal sonography and magnetic resonance imaging are used most frequently to identify and characterise lesions in endometriosis. Subjective impression by an experienced sonologist for identifying endometriomas by ultrasound showed a high accuracy. Adhesions can be evaluated by real-time dynamic transvaginal sonography, using the sliding sign technique, to determine whether the uterus and ovaries glide freely over the posterior and anterior organs and tissues. Diagnosis is difficult when ovarian endometriomas are absent and endometriosis causes adhesions and deep infiltrating nodules in the pelvic organs. Magnetic resonance imaging seems to be useful in diagnosing all locations of endometriosis, and its diagnostic accuracy is similar to those obtained using ultrasound. Transvaginal ultrasound has been proposed as first line-line imaging technique because it is well accepted and widely available. The main limitation of ultrasound concerns lesions located above the rectosigmoid junction owing to the limited field-of-view of the transvaginal approach and low accuracy in detecting upper bowel lesions by transabdominal ultrasound. A detailed non-invasive diagnosis of the extension in the pelvis of endometriosis can facilitate the choice of a safe and adequate surgical or medical treatment

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“…Recto-sigmoid endometriosis may produce nonspecific symptoms such as diarrhea, rectal bleeding, and abdominal colic-like pain. This condition may require open surgery, and when the colon serosa is involved, meticulous dissection is required (3,4). Therefore, accurate preoperative imaging of recto-sigmoid involvement is important.…”

mentioning

confidence: 99%

“…The ''tenderness-guided'' TVUS (tg-TVUS) technique has shown promising results in the detection of DIE (7). MRI enables precise mapping of the nodules of endometriosis and is accepted as a valid imaging technique for evaluation of DIE before surgery (3,(8)(9)(10). However, the diagnostic value of the different signal intensities (hyper/ hypo/iso) shown by a nodule of endometriosis is still controversial.…”

mentioning

confidence: 99%

MRI and “Tenderness Guided” transvaginal ultrasonography in the diagnosis of recto‐sigmoid endometriosis

Saba

Guerriero

Sulcis

et al. 2011

Magnetic Resonance Imaging

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Purpose: To compare the diagnostic accuracy of MRI and ''tenderness-guided'' transvaginal ultrasonography (tg-TVUS) in the identification of recto-sigmoid endometriosis. Materials and Methods:Institutional Review Board approval for this study was obtained, and written informed consent was given by all patients. This study is compliant with the STARD (Standards for Reporting of Diagnostic Accuracy) method. Fifty-nine patients (mean age, 33 years; range, 21-44 years) with clinical suspicion of deep pelvic endometriosis were prospectively enrolled. They underwent tg-TVUS and MRI before surgery. The characteristics of the MRI signal were analyzed. Mapping of recto-sigmoid endometriosis was performed and tg-TVUS and MR imaging results were compared with surgical and pathological findings. Sensitivity, specificity, and the positive and negative likelihood ratio (LRþ and LRÀ) were calculated. Inter-technique concordance was assessed using the Cohen statistic, and receiver operating characteristic (ROC) curves were obtained. Logistic regression analysis was performed.Results: The prevalence of recto-sigmoid endometriosis was 51%. The specificity, sensitivity, and LRþ and LRÀ were 90%, 73%, 7.089 and 0.297, respectively, for MRI and 86%, 73%, 5.317 and 0.309, respectively, for tg-TVUS. The presence of a high T1 signal spot was an excellent specific finding (100%) but was associated with a low sensitivity (30%). Inter-technique concordance using the Cohen statistic indicated a kappa value of 0.658 (6 0.098 SD). According to the logistic regression equation obtained, the use of both tg-TVUS and MRI allows optimal diagnostic performance.Conclusion: MRI and tg-TVUS show similar results in the identification of recto-sigmoid endometriosis. The Cohen kappa value suggests that these methods may have complementary roles in the identification of recto-sigmoid endometriosis, depending on the site affected.

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Endometriosis: Contribution of 3.0-T Pelvic MR Imaging in Preoperative Assessment—Initial Results

Abstract: MR imaging of the pelvis at 3.0 T is accurate in the diagnosis and staging of deep endometriosis for the preoperative assessment of patients clinically suspected of having endometriosis.

Cited by 120 publications

References 28 publications

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

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

Imaging for the evaluation of endometriosis and adenomyosis

MRI and “Tenderness Guided” transvaginal ultrasonography in the diagnosis of recto‐sigmoid endometriosis

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