Open AccessAccuracy of magnetic resonance imaging in diagnosis of deeply infiltrating endometriosis
Author(s) -
Mohamed Fouad Sherif,
Manal Ezzat Badawy,
Dina Gamal Eldeen Y. Elkholi
Publication year - 2015
Publication title -
the egyptian journal of radiology and nuclear medicine /the egyptian journal of radiology and nuclear medicine
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.19
H-Index - 13
eISSN - 2090-4762
pISSN - 0378-603X
DOI - 10.1016/j.ejrnm.2014.11.009
Subject(s) - medicine , endometriosis , adenomyosis , magnetic resonance imaging , radiology , pouch , pelvic pain , surgery , gynecology
ObjectiveTo determine the accuracy of MRI and diffusion weighted images in the diagnosis of deep infiltrating endometriosis (DIE).Patients and methodsThis study included 72 patients (mean age, 28years; range, 17–41years). 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 1.5T MRI system and no contrast medium was used for imaging.ResultsIn 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.ConclusionIn conclusion, preoperative MRI is an excellent tool to provide a reasonably accurate mapping of multiple sites of pelvic endometriosis with high accuracy