Location-dependent value of pelvic MRI in the preoperative diagnosis of endometriosis

Krüger, Karsten; Behrendt, Kai; Niedobitek-Kreuter, G; Koltermann, Katharina C.; Ebert, Andreas D.

doi:10.1016/j.ejogrb.2013.02.007

Cited by 48 publications

(41 citation statements)

References 39 publications

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“…The high accuracy of TVS in detecting and describing DIE lesions is similar to or better than that observed in recent studies on MRI (8,10,11,18). All MRI techniques may cause potential discomfort for the patient because of bowel preparation and the use of intravenous contrast medium.…”

Section: Discussionsupporting

confidence: 73%

“…To detect DIE extension into the pelvis, use of magnetic resonance imaging (MRI) (7)(8)(9)(10)(11)(12) and transvaginal sonography (TVS) (6,(13)(14)(15)(16)(17)(18) have been described. The MRI provides accurate information about lesions located on the upper level of the sigmoid, but for pelvic disease TVS is equally accurate and is considered the first and most widely used diagnostic tool (6,(18)(19)(20).…”

mentioning

confidence: 99%

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Ultrasound mapping system for the surgical management of deep infiltrating endometriosis

Exacoustòs

Malzoni²,

Giovanni³

et al. 2014

Fertility and Sterility

134

143

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Objective: To assess the accuracy of transvaginal sonography (TVS) in defining size and location of deep infiltrating endometriosis (DIE) with laparoscopic/histologic confirmation. Design: Prospective observational study. Setting: University hospital. Patient(s): One hundred four women with suspected DIE on the basis of TVS. Intervention(s): Patients with DIE underwent TVS evaluation before laparoscopic surgery. An accurate mapping of the extent of the disease was recorded during TVS and at laparoscopy. This new mapping system was developed to assess the extent of endometriosis by measuring the size and depth of the lesions at the various pelvic locations. Main Outcome Measure(s): Surgical and histologic confirmation of the ultrasonographic data to evaluate the presence and location of DIE and creation of a new mapping methodology for detecting DIE by TVS. Result(s): Depending on the different location of the lesions, the accuracy of TVS ranged from 76%-97%. The lowest sensitivity (59%) and accuracy (76%) were obtained for TVS in the diagnosis of vaginal endometriosis, whereas the greatest accuracy (97%) was shown in detecting bladder lesions and Douglas obliteration. Conclusion(s):This new ultrasound mapping system is accurate for detecting the extent of DIE and may be useful for preoperative planning and intraoperative management of symptomatic patients with DIE. (Fertil Steril Ò

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Section: Discussionsupporting

confidence: 73%

mentioning

confidence: 99%

Ultrasound mapping system for the surgical management of deep infiltrating endometriosis

Exacoustòs

Malzoni²,

Giovanni³

et al. 2014

Fertility and Sterility

134

143

View full text Add to dashboard Cite

show abstract

“…Also, the higher costs of carrying out MRI, and the need for expert radiologists, are a limitation of this diagnostic imaging for DIE diagnosis. The high accuracy in detecting and describing DIE lesions by transvaginal sonography is similar or better than those obtained by recent studies on magnetic resonance imaging [56,99,100]. For these reasons, it seems that transvaginal sonography is the best diagnostic tool in mapping DIE [36, [48][49][50]57,58].…”

Section: Resultsmentioning

confidence: 59%

Imaging for the evaluation of endometriosis and adenomyosis

Exacoustòs

Manganaro

Zupi

2014

Best Practice & Research Clinical Obstetrics & Gynaecol

207

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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“…Magnetic resonance imaging (MRI) is becoming a mainstay of preoperative diagnostics, in particular for diagnosing deep infiltrating endometriosis [10][11][12][13][14][15][16][17]. MRI sensitivity and specificity depends on the localization of endometriosis [17].…”

Section: Introductionmentioning

confidence: 99%

“…MRI sensitivity and specificity depends on the localization of endometriosis [17]. The most important technique for MRI uses T2-weighted and T1-weighted sequences.…”

Section: Introductionmentioning

confidence: 99%

Magnet Resonance Imaging in Preoperative Endometriosis: Incidence of High-Signal-Intensity Spots on Fat-Suppressed T1-Weighted and T2-Weighted Images

Krüger¹

2017

OGIJ

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Objectives: To investigate the incidence of high-signal-intensity lesions at preoperative T1 and T2-weighted magnet resonance imaging (MRI) in patients with pelvic endometriosis.Study Design: Between 2009 and 2012, 252 women with clinical and sonographic suspicion of endometriosis underwent pelvic MRI using T2 and unenhanced T1 sequences with and without fat saturation. Two radiologists interpreted the following regions retrospectively by consensus according to a standardized protocol: uterus, vagina, pouch of Douglas, rectum, uterosacral ligament (USL). High-signal-intensity lesions in the fat-suppressed T1-weighted images were defined as hemorrhagic foci. Their incidence and that of high-signal-intensity spots in T2-weighted images were documented in histopathological verified endometriosis. Results:In patients with rectal endometriosis (128/252 patients), high-signalintensity spots were detected on 10.2% of T1-weighted fat-suppressed images and on 16.9% of T2-weighted images. In uterus adenomyosis (236/252 patients) high-signal-intensity spots on T1 and T2 weighted images occurred in 43.2% and 24.2%, respectively (vagina (115/252, 31.3% and 41.9%; USL 119/252, 7.6% and 13.8%, pouch of Douglas 169/252, 31.4% and 28.1%, other localizations 7/252, 71.4% and 57.1%) Conclusion:The incidence of high-signal-intensity spots on T1 and T2-weighted images depends on the localization of endometriosis. T1 und T2 high-signalintensity spots are less relevant in diagnosing endometriosis of the rectum and uterosacral ligament.

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Location-dependent value of pelvic MRI in the preoperative diagnosis of endometriosis

Cited by 48 publications

References 39 publications

Ultrasound mapping system for the surgical management of deep infiltrating endometriosis

Ultrasound mapping system for the surgical management of deep infiltrating endometriosis

Imaging for the evaluation of endometriosis and adenomyosis

Magnet Resonance Imaging in Preoperative Endometriosis: Incidence of High-Signal-Intensity Spots on Fat-Suppressed T1-Weighted and T2-Weighted Images

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