The Significance of magnetic resonance imaging in the diagnostics of endometriosis

Background. Endometriosis is a common gynecological disease characterized by ectopic endometrial lesions found outside the uterus and it affects up to 10 % of women in reproductive age. Currently, the preferred method for diagnosis and treatment of endometriosis is laparoscopy but like every invasive procedure it mandates a revaluation of the risks involved. Despite magnetic resonance imaging (MRI) is considered as the best non-invasive method for endometriosis determination, nowadays research for new MRI techniques is made to improve surgical approach and optimize diagnosis. Aim. To identify the significance of MRI in the diagnostics of endometriosis. Materials and methods. This study included 39 women who had MRI for deep pelvic endometriosis in the Hospital of Lithuanian University of Health Sciences Kaunas Clinics in 2012. 28 women in control group had standard MRI. 11 women in study group had MRI after intra-vaginal and intra-rectal opacification with ultrasonographic gel. Results. Endometriotic lesions were found in 82 % of patients (90.9 % in study group and 78.6 % in control group). The sensitivity of MRI for detection of deep endometriotic lesions was 100 % in study group and 91.3 % in control group, the specificity – 50 % and 80 %, positive predictive value (PPV) – 90 % and 95.4 %, negative predictive value (NPV) – 100 % and 66.7 %, accuracy – 90.9 % and 89.2 %. Conclusions. Conventional MRI is characterized by high sensitivity, specificity, PPV and accuracy as well as moderate NPV in the investigation of deep endometriosis. MRI after intra-vaginal and intra-rectal gel opacification has a higher sensitivity, NPV and accuracy, but lower specificity and PPV than conventional MRI. In our study the most common sites for endometriotic lesions were posterior wall of the uterus and ovaries. The results did not differ significantly in study and control groups