{"paper_id":"31cec8ce-6ffe-4e3d-ad51-75a48a9f7ef9","body_text":"ECR 2010 / C-1232\nMagnetic resonance inter-observer agreement in the analysis of deep pelvic endometriosis\nCongress:\nECR 2010\nPoster Number:\nC-1232\nType:\nScientific Exhibit\nKeywords:\nGenital / Reproductive system female, Obstetrics (Pregnancy / birth / postnatal period), Pelvis\nAuthors:\nL. Saba, S. Guerriero, R. Sulcis, M. Pilloni, G. Melis, G. Mallarini; Cagliari/IT\nDOI:\n10.1594/ecr2010/C-1232\nPurpose\nEndometriosis is defined as the presence of endometrium-like tissue in sites outside the uterine cavity (ectopic as opposed to normally located or eutopic endometrium). The ectopic endometrium responds to hormonal stimulation with various degrees of cyclic hemorrhage and symptoms. Endometriosis is a common and important clinical problem of women, predominantly those in the reproductive age group and it affects 5 to 10% of women of reproductive age in the United States of America. The mean age at diagnosis is 25-29 years and it is often...\nMethods and Materials\n83 consecutive female patients (mean age 39; range 19-49) were studied by using MRI in our Center. Each patient was suspected of having endometriosis at clinical examination (pelvic pain, infertility, nodules or tenderness at physical examination) and prior to MRI, underwent transvaginal sonography (TV-US) performed by an experienced gynecological sonographist.All examinations were performed with a Gyroscan 1.5-T superconducting magnet . In all 83 exams a body coil was used for imaging of the pelvis. Before each exam patients were asked to perform an intestinal toilette...\nResults\nOf the 83 MRI examinations performed 12 demonstrated no evidence of disease. In the remaining 71 patients, 157 endometriotic lesions ranging in size from 0.4 to 6.2 cm were detected. In 22 patients isolated disease was detected whereas in 49 patients multifocal endometriotic lesions were present.In the ovary, the inter-observer agreement was 92.77% and the kappa value 0.802 (95% CI from 0.695 to 0.91). In the bladder the inter-observer agreement was 96.39% and the kappa value 0.553 (95% CI from 0.056 to 1). In the...\nConclusion\nThe results of this study suggest that MRI produces different agreements in detecting endometriosis according to the anatomical location. Several imaging techniques have been used to identify endometriosis and to assess its extent in specific locations such as the vaginal fornix, the bladder, the USLs and the pouch of Douglas with varying results. Accurate depiction of the extent of the disease, in particular deep endometriosis, is extremely important for correct pre-surgical planning by helping in the analysis of lesions that are difficult or impossible to...\nReferences\nHealy DL, Trounson AO, Andersen AN. Female Infertility: causes and treatment. Lancet 1994;343:1539-44.Goldstein DP, deCholnoky C, Emans SJ, Leventhal JM. Laparoscopy in the diagnosis and management of pelvic pain in adolescents. J Reprod Med 1989;24:251-256.Koninckx PR, Martin D. Treatment of deeply infiltrating endometriosis. Curr Opin Obstet Gynecol 1994; 6:231-241.Imaoka I, Wada A, Matsuo M, Yoshida M, Kitagaki H, Sugimura K. MR imaging of disorders associated with female infertility: use in diagnosis, treatment ad management. Radiographics 2003;23:1401-21.Guerriero S, Mais V, Ajossa S, Paoletti AM, Angiolucci M,...","source_license":"CC0","license_restricted":false}