Magnetic Resonance Imaging

In: Clinical Management of Bowel Endometriosis · 2020 · pp. 65–78 · doi:10.1007/978-3-030-50446-5_7 · W4236766587
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Magnetic resonance imaging (MRI) is a recommended second-line technique for preoperative assessment of deep endometriosis, offering high sensitivity and specificity for diagnosing bowel involvement.

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This paper reviews how pelvic MRI is used in the diagnosis and preoperative assessment of deep infiltrating endometriosis, with emphasis on bowel endometriosis as the most common extragenital site. It describes high-level evidence that MRI (including MR enterography and fusion imaging techniques) can map bowel lesion location, number (unique vs multifocal/multicentric), and size, with reported sensitivity and specificity for intestinal involvement of about 95% and 100%. The chapter explicitly frames MRI mainly as a second-line technique in the preoperative workup, noting that clinical exam and laparoscopy remain diagnostic references for extent in some contexts. This paper is centrally about endometriosis — specifically the role and diagnostic performance of magnetic resonance imaging for bowel and deep infiltrating disease planning.

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Abstract

Pelvic endometriosis affects around 10% of women of reproductive age. Bowel endometriosis is one of the most severe forms and is the most common site of extragenital endometriosis. In women with deep infiltrating endometriosis, bowel endometriosis affects between 12% and 37% of women. Diagnosis of the extension of deep pelvic endometriosis can be made by clinical examination and laparoscopic exploration. Recent advances in imaging techniques may replace the gold standard of diagnostic laparoscopy for some locations of deep endometriosis. MRI is recommended as a second-line technique in the preoperative workup of deep endometriosis (Grade A). The sensitivity and specificity of MR imaging (MRI) for the diagnosis of intestinal involvement are around 95% and 100%, respectively. MRI allows to diagnose location of bowel endometriosis involvement, number (unique, multifocal, and/or multicentric), size to help surgeon. MR enterography is widely used to explore small-bowel and ileocecal diseases and fusion imaging can help in difficult case. Access this chapter Tax calculation will be finalised at checkout Purchases are for personal use only Similar content being viewed by others

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Author information Authors and Affiliations Corresponding author Editor information Editors and Affiliations Rights and permissions Copyright information © 2020 Springer Nature Switzerland AG About this chapter Cite this chapter Abdel-Wahab, C. et al. (2020). Magnetic Resonance Imaging. In: Ferrero, S., Ceccaroni, M. (eds) Clinical Management of Bowel Endometriosis. Springer, Cham. https://doi.org/10.1007/978-3-030-50446-5_7 Download citation DOI: https://doi.org/10.1007/978-3-030-50446-5_7 Published: Publisher Name: Springer, Cham Print ISBN: 978-3-030-50445-8 Online ISBN: 978-3-030-50446-5 eBook Packages: MedicineMedicine (R0)

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