Incidental findings on MRI for the evaluation of endometriosis: prevalence and clinical significance

Harth, Sebastian, Roller, Fritz Christian, Brose, Alexander, Kaya, Hasan Emin, Zeppernick, Felix, Meinhold-Heerlein, Ivo, Krombach, Gabriele Anja, Justus Liebig University Giessen
2024 · doi:10.22029/jlupub-19451 · W6888895900
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This retrospective study of 303 patients found that incidental findings on pelvic MRI for endometriosis are highly prevalent, with significantly higher rates in those with deep infiltrating disease, though most lack clinical significance.

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This retrospective, descriptive cross-sectional single-center study analyzed the prevalence and potential clinical significance of incidental findings on pelvic MRI performed for endometriosis between April 2021 and February 2023, comparing patients with versus without imaging evidence of deep infiltrating endometriosis. Among 303 consecutive patients, incidental findings were reported in 299 (98.7%), most commonly hip acetabular rim ossification and degenerative lumbar spine changes, and 25 (8.3%) had high clinical significance. For specific incidental findings, prevalences were significantly higher in patients with deep infiltrating endometriosis on MRI for hip acetabular rim ossification, annulus fibrosus fissures, and gallstones. The study’s key limitation is its single-center retrospective design and reliance on incidental findings noted in images and radiology reports without a broader multi-center validation. This paper is centrally about endometriosis — it evaluates incidental MRI findings encountered during endometriosis assessment and their clinical significance, including comparisons by deep infiltrating endometriosis status.

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Abstract

Objectives: This study aimed to analyze the prevalence and clinical significance of incidental findings on MRI for endometriosis. Differences between patients with and without evidence of deep infiltrating endometriosis on MRI were to be examined. Methods: This was a retrospective, descriptive cross-sectional single-center study. All patients who received a pelvic MRI for endometriosis between April 2021 and February 2023 were included. The presence and frequency of incidental findings were noted after review of all MR images and radiology reports. The potential clinical significance of the findings was analyzed. Differences in the frequency of incidental findings between patients with and without evidence of deep infiltrating endometriosis on MRI were evaluated, utilizing the Chi-square test, Fisher's exact test and Mann–Whitney U-test. Results: 303 consecutive patients (mean age, 33.4 years ± 8.3) were evaluated. Incidental findings were noted in 299/303 (98.7%) patients. Most frequently, ossification of the hip acetabular rim and degenerative changes of the lumbar spine were noted. In 25/303 (8.3%) patients, incidental findings had high clinical significance. For specific incidental findings, significantly higher prevalences were found in patients with than in patients without evidence of deep infiltrating endometriosis on MRI (hip acetabular rim ossification, p = 0.041; annulus fibrosus fissures, p = 0.006; gallstones, p = 0.042). Conclusions: Incidental findings are very common on pelvic MRI for endometriosis. The detection of incidental findings can lead to the diagnosis of relevant diseases and thus enable early treatment. On the other hand, many incidental findings have no, only minor, or uncertain consequences.
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Incidental findings on MRI for the evaluation of endometriosis: prevalence and clinical significance Loading... Date Advisors/Reviewers Further Contributors Contributing Institutions Publisher Journal Title Journal ISSN Volume Title Publisher License Quotable link DOI: https://doi.org/10.22029/jlupub-19451Abstract Objectives: This study aimed to analyze the prevalence and clinical significance of incidental findings on MRI for endometriosis. Differences between patients with and without evidence of deep infiltrating endometriosis on MRI were to be examined. Methods: This was a retrospective, descriptive cross-sectional single-center study. All patients who received a pelvic MRI for endometriosis between April 2021 and February 2023 were included. The presence and frequency of incidental findings were noted after review of all MR images and radiology reports. The potential clinical significance of the findings was analyzed. Differences in the frequency of incidental findings between patients with and without evidence of deep infiltrating endometriosis on MRI were evaluated, utilizing the Chi-square test, Fisher's exact test and Mann–Whitney U-test. Results: 303 consecutive patients (mean age, 33.4 years ± 8.3) were evaluated. Incidental findings were noted in 299/303 (98.7%) patients. Most frequently, ossification of the hip acetabular rim and degenerative changes of the lumbar spine were noted. In 25/303 (8.3%) patients, incidental findings had high clinical significance. For specific incidental findings, significantly higher prevalences were found in patients with than in patients without evidence of deep infiltrating endometriosis on MRI (hip acetabular rim ossification, p = 0.041; annulus fibrosus fissures, p = 0.006; gallstones, p = 0.042). Conclusions: Incidental findings are very common on pelvic MRI for endometriosis. The detection of incidental findings can lead to the diagnosis of relevant diseases and thus enable early treatment. On the other hand, many incidental findings have no, only minor, or uncertain consequences.Link to publications or other datasets Description Notes Original publication in Frontiers in medicine 11 (2024), 1 - 12, 1468860

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