MR staging of pelvic endometriosis: role of fat-suppression T1-weighted images.
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This study found that MR imaging can stage advanced pelvic endometriosis according to the r-AFS system, with fat-suppression T1-weighted images improving visualization of small peritoneal implants.
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Abstract
We examined whether MR can determine the stage of endometriosis according to the scoring system established and revised by the American Fertility Society (r-AFS), a system which is widely used by gynecologists. We also studied the utility of fat suppression T1-weighted images in improving accuracy. Seventeen patients with endometriosis examined by conventional MR were included in this study. All the patients had surgically proved stage III or IV disease. We determined the stage by MR using the following criteria according to the r-AFS system: adnexal masses without normal ovarian tissue were considered deep ovarian lesions, while those with normal tissue were considered superficial. A lack of fat between the lesion and surrounding structures was considered a dense adhesion, and hyperintense spots were considered peritoneal implants. The MR scores of patients with and without fat suppression were correlated with the surgical scores. MR staging corresponded to surgical staging in 15 of the 17 patients. In eight patients, peritoneal implants of less than 1.5 cm were depicted only by fat-suppression images. However, these lesions did not change the score significantly. MR imaging could determine the stage in advanced endometriosis. Fat-suppression could highlight smaller implants. These tiny lesions had little clinical meaning in these advanced cases; however, the clinical value of this technique should be evaluated in milder disease.
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Cited by (26)
- Strengths and limitations of diagnostic tools for endometriosis and relevance in diagnostic test accuracy research 2022
- Protocolo de ressonância magnética na avaliação pré-operatória da endometriose profunda 2021
- Repression of <i>FBXW7</i> by <i>HES5</i> contributes to inactivation of the <i>TGF‐β</i> signaling pathway and alleviation of endometriosis 2021
- Endometriosis in Adolescent Girls 2020
- RETIRED: No. 164-Consensus Guidelines for the Management of Chronic Pelvic Pain 2018
- RETIRED: No 164 - Directive clinique de consensus pour la prise en charge de la douleur pelvienne chronique 2018
- Recommandations de la Société européenne d’imagerie génito-urinaire : IRM de l’endométriose pelvienne 2017
- Current methods for the management of endometriosis in adolescent patients 2016
- European society of urogenital radiology (ESUR) guidelines: MR imaging of pelvic endometriosis 2016
- Endometriosis diagnosis and staging by operating surgeon and expert review using multiple diagnostic tools: an inter‐rater agreement study 2015
- Bladder endometriosis: characterization by magnetic resonance imaging and the value of documenting ureteral involvement 2014
- MR Imaging of Endometriosis 2014
- Location-dependent value of pelvic MRI in the preoperative diagnosis of endometriosis 2013
- Endometriosis: Disease Classification and Behavior 2011
- MRI of Endometriotic Cysts in Association With Ovarian Carcinoma 2010
- Anatomic Significance of a Positive Barium Enema in Deep Infiltrating Endometriosis of the Large Bowel 2009
- Ce qu’attend le chirurgien de l’imagerie dans l’endométriose profonde 2006
- The role of magnetic resonance imaging in minimal access surgery 2006
- Consensus Guidelines for the Management of Chronic Pelvic Pain 2005
- RETIRED: Directive clinique de consensus pour la prise en charge de la douleur pelvienne chronique 2005
- Preoperative Double-Contrast Barium Enema in Patients with Suspected Intestinal Endometriosis 2004
- Diagnostic accuracy of laparoscopy, magnetic resonance imaging, and histopathologic examination for the detection of endometriosis 2003
- Routine Clinical Examination Is Not Sufficient for Diagnosing and Locating Deeply Infiltrating Endometriosis 2002
- 10.1016/s1879-8543(19)60537-9 2000
- MRI facilitated a diagnosis of endometriosis of the rectum 2000
- CT and MRI appearances of sarcomatous change in chronic pelvic endometriosis. 1998
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