Diagnosis of pelvic endometriosis by magnetic resonance imaging using “fat-saturation” technique

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This paper investigates the diagnostic accuracy of the fat-saturation technique in magnetic resonance imaging for detecting pelvic endometriosis.

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Abstract

ObjectiveTo assess the usefulness of fat-saturated magnetic resonance (MR) imaging for detecting small endometrial implants.DesignProspective evaluation by conventional and fat-saturated MR imaging.SettingShimane Medical University Hospital, Izumo, Japan.PatientsFifty-one consecutive patients with clinically suspected pelvic endometriosis.InterventionsMagnetic resonance images < 2 weeks before laparoscopy or laparotomy.Main outcome measureThe location, number, and size of lesions.ResultsSurgery revealed a normal pelvis in 5 patients, endometriosis in 44 (42 with pigmented lesions and 2 with nonpigmented lesions and adhesions), and other cystic lesions in 2. With fat-saturated MR imaging, overall sensitivity, specificity, positive predictive value, and negative predictive value were 89%, 71%, 95%, and 50%, respectively. At surgery, 122 pigmented lesions of endometriosis were detected. Conventional MR images indicated lesions of endometriosis in 74. When fat-saturated images were used, 103 lesions were detected. With conventional MR images, only one of 34 small endometrial implants (2 to 3 mm in diameter) was detected. However, the addition of fat-saturated images increased the detection rate to 15 of 34, and all lesions > 4 mm in diameter.ConclusionConventional MR imaging for detecting small endometrial implants was improved by addition of the fat-saturation technique. Therefore, fat-saturation MR imaging is an acceptable for detecting small endometriomas.

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Condition tags

endometriosis

MeSH descriptors

Endometriosis Lipids Magnetic Resonance Imaging Pelvis Adipose Tissue Adult Endometriosis Endometriosis Endometriosis Female Humans Laparoscopy Laparotomy Magnetic Resonance Imaging Middle Aged Ovarian Diseases Ovarian Diseases Ovarian Diseases Prospective Studies

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