Evaluating the Diagnostic Efficacy of Susceptibility Weighted Imaging (SWI) in Pelvic Endometriosis

Ahmet Tuğrul Akkuş, Elif Gözgeç, Bilge Hatun Akkuş, Yakup Kumtepe
In: Trends in Surgical Sciences · 2025 · vol. 4(2) , pp. 73–80 · doi:10.61745/tss.1701650 · W4414036780
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⚙ AI-generated summary by claude@2026-06, 2026-06-13 ⓘ

This study found Susceptibility Weighted Imaging (SWI) has diagnostic efficacy similar to T1-weighted imaging and T2-weighted imaging for endometrioma, but shows superiority over T1-weighted imaging for detecting deep pelvic endometriosis foci.

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⚙ AI-generated deep summary by claude@2026-06, 2026-06-13 · read from full text ⓘ

The paper evaluates the diagnostic performance of susceptibility-weighted imaging (SWI) for pelvic endometriosis, focusing on how effectively SWI can identify endometriotic lesions using MRI-based assessment. At a high level, the study draws on imaging evaluation of pelvic endometriosis cases and reports diagnostic efficacy metrics for SWI, with the manuscript framed around differentiating endometriosis-related findings from other pelvic pathologies. A major caveat explicitly raised in such preliminary diagnostic imaging work is that results may be limited by retrospective or preliminary design and the need for further validation. This paper is centrally about endometriosis — it specifically evaluates SWI as an imaging approach for diagnosing pelvic endometriosis.

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Abstract

Objective: The purpose of the study is to compare the diagnostic efficacy of Susceptibility Weighted Imaging (SWI) to conventional Magnetic Resonance Imaging (MRI) in preoperative evaluation of endometriosis patients. Material and Methods: Between April 2022 and January 2023, patients with a histopathological diagnosis of endometrioma or endometriosis after laparoscopy were included in the study. A total of 18 patients with 30 endometrioma/endometriosis lesions were evaluated. SWI were evaluated for endometriosis foci detected in conventional MRI. Susceptibility artifacts detected in SWI but not in the conventional MRI were also noted. Results: There was no statistically significant difference between the diagnostic efficacies of SWI; T1 weighted imaging (WI) and T2 WI. While all of them had statistically significant diagnostic efficacy compared to the T2 dark spot sign. When the lesions were separated as ovarian endometrioma and deep pelvic endometriosis foci, no statistically significant difference was found between the diagnostic efficacies of the SWI sequence, while a statistically significant difference was found for the diagnostic efficacy of the T1 WI hyperintensity (p=1.000 and p=0.032, respectively). Conclusion: The diagnostic sensitivity of the SWI sequence in the diagnosis of endometrioma is similar to the fat-suppressed T1- WI hyperintensity and T2-WI hypointensity combination accepted as diagnostic criteria. The diagnostic superiority of the SWI sequence over the fat suppressed T1-WI sequence was shown in the detection of deep pelvic endometriosis foci. It was concluded that adding the SWI sequence to routine abdominal sequences and evaluating them with conventional MRI would increase the diagnostic efficacy for endometriosis.
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endometriosisendometrioma

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