Evaluation of MR diffusion-weighted imaging in differentiating endometriosis infiltrating the bowel from colorectal carcinoma

M P H Busard, Busard MP, Mph Busard, I C Pieters-van den Bos, Indra C. Pieters-van den Bos, Pieters-van den Bos IC, V. Mijatovic, Velja Mijatovic, van Kuijk C, C. van Kuijk, Maaike C.G. Bleeker, M C G Bleeker, J H T M van Waesberghe, van Waesberghe JH, Jhtm van Waesberghe
European journal of radiology · 2011 · vol. 81(6) , pp. 1376–1380 · doi:10.1016/j.ejrad.2011.03.038 · PMID:21493029 · W2105578243
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This study evaluated the efficacy of MR diffusion-weighted imaging in distinguishing bowel-infiltrating endometriosis from colorectal carcinoma based on imaging characteristics.

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Abstract

ObjectiveEndometriosis infiltrating the bowel may be difficult to differentiate from colorectal carcinoma in cases that present with non-specific clinical and imaging features. The aim of this study is to assess the value of MR diffusion-weighted imaging (DWI) in differentiating endometriosis infiltrating the bowel from colorectal carcinoma.MethodsIn 66 patients, MR DWI was added to the standard imaging protocol in patients visiting our outdoor MR clinic for the analysis of suspected or known deep infiltrating endometriosis (DIE). In patients diagnosed with DIE infiltrating the bowel on MR imaging, high b-value diffusion-weighted images were qualitatively assessed by two readers in consensus and compared to high b-value diffusion weighted images in 15 patients evaluated for colorectal carcinoma. In addition, ADC values of lesions were calculated, using b-values of 50, 400 and 800 s/mm(2).ResultsA total of 15 patients were diagnosed with DIE infiltrating the bowel on MR imaging. Endometriosis infiltrating the bowel showed low signal intensity on high b-value diffusion-weighted images in all patients, whereas colorectal carcinoma showed high signal intensity on high b-value diffusion-weighted images in all patients. Mean ADC value in endometriosis infiltrating the bowel (0.80 ± 0.06 × 10(-3)mm(2)/s) was significantly lower compared to mean ADC value in colorectal carcinoma (0.86 ± 0.06 × 10(-3 )mm(2)/s), but with considerable overlap between ADC values.ConclusionOnly qualitative assessment of MR DWI may be valuable to facilitate differentiation between endometriosis infiltrating the bowel and colorectal carcinoma.

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Condition tags

endometriosis

MeSH descriptors

Colorectal Neoplasms Diffusion Magnetic Resonance Imaging Endometriosis Aged Aged, 80 and over Colorectal Neoplasms Colorectal Neoplasms Diagnosis, Differential Diffusion Magnetic Resonance Imaging Endometriosis Endometriosis Female Humans Intestines Intestines Male Middle Aged Retrospective Studies Statistics, Nonparametric

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