Usefulness of subtraction pelvic magnetic resonance imaging for detection of ovarian endometriosis

Abstract

Background: To minimize damage to the ovarian reserve, it is necessary to evaluate the follicular density in the ovarian tissue surrounding endometriosis on preoperative imaging. The purpose of the present study was to evaluate the usefulness of subtraction pelvic magnetic resonance imaging (MRI) to detect ovarian reserve. Methods: A subtracted T1-weighted image ( sub T1WI) was obtained by subtracting unenhanced T1WI from contrast-enhanced T1WI ( ce T1WI) with similar parameters in 22 patients with ovarian endometriosis. The signal-to-noise ratio (SNR) in ovarian endometriosis, which was classified into the high signal intensity and iso-to-low signal intensity groups on the T2-weighted image, was compared to that in normal ovarian tissue. To evaluate the effect of contrast enhancement, a standardization map was obtained by dividing sub T1WI by ce T1WI. Results: On visual assessment of 22 patients with ovarian endometriosis, 16 patients showed a high signal intensity, and 6 patients showed an iso-to-low signal intensity on T1WI. Although SNR in endometriosis with a high signal intensity was higher than that with an iso-to-low signal intensity, there was no difference in SNR after the subtraction (13.72±77.55 vs. 63.03±43.90, p=0.126). The area of the affected ovary was smaller than that of the normal ovary (121.10±22.48 vs. 380.51±75.87 mm 2 , p=0.002), but the mean number of pixels in the viable remaining tissue of the affected ovary was similar to that of the normal ovary (0.53±0.09 vs. 0.47±0.09, p=0.682). Conclusion: The subtraction technique used with pelvic MRI could reveal the extent of endometrial invasion of the normal ovarian tissue and viable remnant ovarian tissue.

Magnetic resonance imaging texture analysis for the evaluation of viable ovarian tissue in patients with ovarian endometriosis: a retrospective case-control study

“…However, this study focused on the role of contrast agents in the evaluation of adjacent surviving ovarian tissue invaded by endometriosis. The perfusion map could be used for the analysis of viable tissue within this subset of cystic ovarian masses according to the severity of endometriosis for preoperative evaluation [14][15][16].…”

Diagnosis and Nursing Intervention of Gynecological Ovarian Endometriosis with Magnetic Resonance Imaging under Artificial Intelligence Algorithm

“…Because of the advantages of multiparameter and multisequence imaging and high tissue resolution, a plain scan of MRI is very suitable for the diagnosis and staging of deep infiltrating endometriosis. It helps a lot to find vaginal rectal septum or rectal mass and identify the relationship between the mass and the surrounding organs like the intestine and bladder clearly, but there are still limitations in image noise and image detail imaging [ 11 ]. In addition, traditional MRI diagnosis often requires a comprehensive diagnosis by professional physicians, with effective information in the images and various characteristics of the patients.…”