Deep pelvic endometriosis: MR colonography increases the detection of colorectal involvement

Genital / Reproductive system female, Obstetrics (Pregnancy / birth / postnatal period), Pelvis Authors: A. Scardapane, S. Bettocchi, M. Lasciarrea, F. Lorusso, A. A. A. Stabile Ianora, M. Moschetta, G. Angelelli; Bari/IT DOI: 10.1594/ecr2010/C-1295 Purpose To compare the accuracy of pelvic MRI and MR colonography (MRC) in the detection of colorectal endometriosis.

and Materials Sixty-one consecutive women with suspicion of endometriosis underwent pelvic MRI which was completed with contrast enhanced MRC. MRI and MRC were considered as two dataset which were independently reviewed by two radiologists respectively with 3 years (R1) and 10 years (R2) experience. The presence of ovarian endometriomas, pelvic nodules, Douglas obliteration, and colorectal nodules were recorded. MR findings were correlate to laparoscopy in all the cases.

Sixty-five endometriomas were found in 56/61 patients (size 0,5-70 mm, mean 2,8 mm) by both the radiologists. Pelvic nodule were found in 16 women, while an obliterated douglas pouch was shown in 9 patients by R1 and R2. Colorectal involvement was diagnosed at pelvic MRI in 4/61 cases by R1 and in 9/61 cases by R2 (k= 0,57). Using MRC, colorectal involvement was shown in 10/61 cases and 11/61 cases respectively (K=0,94). Laparoscopy demonstrated the presence of colorectal involvement in 13/61 with no false positive...

The combinations of pelvic MRI and MRC increases the sensitivity and NPV in the detection of colorectal endometriosis. Moreover an higher interobserver agreement is achieved using MRC compared with pelvic MRI.

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