The Importance and Perspective of Magnetic Resonance Imaging in the Evaluation of Endometriosis

Abstract

MR imaging is becoming increasingly important in the assessment of patients with endometriosis. Its multiplanar capabilities and superior soft tissue contrast are particularly useful in the detection of deep infiltrating endometriotic implants. Endometriosis, defined as the presence of endometrial glands and stroma outside the endometrium, is among the most common gynaecological disorders affecting women in their reproductive age. The diagnosis and evaluation of the extension of endometriosis are difficult only with physical examination and laparoscopy. According to the authors' personal experience, a special MRI technique and some imaging guidelines regarding different anatomical localizations of endometriosis are discussed. This review is a brief presentation of current evidence on the diagnostic accuracy of MRI in the evaluation of endometriosis concerning other diagnostic methods, the limitations of MRI and its essential usefulness for preoperative diagnosis of deep pelvic endometriosis, and future perspectives in monitoring this disease.

An evidence‐based approach to assessing surgical versus clinical diagnosis of symptomatic endometriosis

“…Owing to its higher costs relative to other imaging modalities, magnetic resonance imaging (MRI) is less frequently applied for the assessment of endometriosis. However, MRI is useful in cases where ultrasonography findings are equivocal and in carefully selected, high‐risk patients (e.g., those with extensive pelvic adhesions of suspected ureteral involvement) . Nonetheless, this method is helpful for cases where ultrasonographic findings are equivocal or for use among carefully selected high‐risk patients such as those with extensive pelvic adhesions or suspected ureteral involvement .…”

“…However, MRI is useful in cases where ultrasonography findings are equivocal and in carefully selected, high‐risk patients (e.g., those with extensive pelvic adhesions of suspected ureteral involvement) . Nonetheless, this method is helpful for cases where ultrasonographic findings are equivocal or for use among carefully selected high‐risk patients such as those with extensive pelvic adhesions or suspected ureteral involvement . One advantage of MRI is that interpretation of the results is less operator‐dependent compared with TVUS .…”

Ultrasound techniques in the diagnosis of deep pelvic endometriosis: algorithm based on a systematic review and meta-analysis

“…This alone has a fundamental role when counseling patients regarding treatment modalities (12). Many studies have suggested transvaginal sonography (TVS) as a good method to identify DPE (12)(13)(14)(15)(16) since this technique allows extensive exploration of the pelvis and is usually well accepted and widely available (4,15).…”

“…Moreover, the choice regarding one method rather than another remains ''empirical'' or based on personal experience (9,(13)(14)(15)(16)(19)(20)(21)(22)(23). Therefore, the aim of this study was to collate all available data and to compare the efficacy of each method to the others to identify the most effective technique to assist clinicians in the diagnosis, assessment, and localization of DPE.…”

Magnetinio Rezonanso Tomografijos Reikšmė Diagnozuojant Endometriozę

“…MRT yra laikomas tiksliausiu tyrimo metodu priešope-raciniam giliosios endometriozės židinių įvertinimui [17]. Intraveninės kontrastinės medžiagos panaudojimas nepadeda diferencijuoti endometriozės židinių nuo aplinkinių fibromuskulinių struktūrų, o kontrastinės medžiagos susikaupimas parametriumo audiniuose arba smulkiose kraujagyslėse gali būti klaidingai palaikytas endometriozės židiniu.…”