Diagnostic value of MRI in chronic pelvic pain: A comparison study using laparoscopy as standard of reference

Pasquale Paolantonio
2010 · doi:10.1594/ecr2010/c-1288 · W2514032203
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This study compared the diagnostic value of MRI to laparoscopy for identifying causes of chronic pelvic pain in women.

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This prospective study evaluated MRI’s sensitivity as part of the preoperative work-up for chronic pelvic pain in 50 women scheduled for laparoscopy, using a 1.5T scanner with T2-weighted and T1-weighted sequences and blind consensus image interpretation by two radiologists. Laparoscopy identified multifactorial causes in 13 patients, including uterine adenomyosis in 25 and deep pelvic endometriosis in 16, along with pelvic adhesions (12) and ovarian endometriomas (10). MRI showed an overall sensitivity of 93% for identifying the origin of pain, with reported sensitivities of 100% for uterine adenomyosis, 83% for deep pelvic endometriosis, and 80% for pelvic adhesions; a key limitation noted in the study’s framed comparison is that performance is reported in terms of sensitivity relative to the laparoscopy reference standard. This paper is centrally about endometriosis and adenomyosis—MRI sensitivity for uterine adenomyosis and deep pelvic endometriosis in women with chronic pelvic pain.

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Abstract

Poster: ECR 2010 / C-1288 / Diagnostic value of MRI in chronic pelvic pain: A comparison study using laparoscopy as standard of reference by: P. Paolantonio, R. Ferrari, M. Rengo, M. M. Maceroni, D. Caruso, A. Laghi; Latina/IT
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Keywords

Genital / Reproductive system female, Obstetrics (Pregnancy / birth / postnatal period), Pelvis Authors: P. Paolantonio, R. Ferrari, M. Rengo, M. M. Maceroni, D. Caruso, A. Laghi; Latina/IT DOI: 10.1594/ecr2010/C-1288 Purpose The purpose of this prospective study was to evaluate the sensitivity of MRI in the preoperative work-up of chronic pelvic pain.

Methods

and Materials We included in the study 50 women (mean age 32 years; age range, 19-45 years) suffering by chronic pelvic pain scheduled for laparoscopy.MRI was performed on a 1.5T scanner (Signa Hde;GE) equipped with 8-channel phased-array coil with parallel imaging capabilities. MR protocol included high resolution TSE T2 W acquired on axial and sagittal plane and TSE T1W sequences acquired on the axial plane using spectral fat saturation. Images analysis was performed by two radiologist in a blind consensus fashion. Readers were asked to identify the...

Results

In 13 patients a multifactorial origin of pelvic pain was discovered. Uterine adenomyosis was founded in 25 patients, deep pelvic endometriosis in 16 patients, pelvic adhesion in 12 patients, ovaric endometriosis in 10 patients.MRI showed an overall sensitivity of 93% in the identification of the origin of chronic pelvic pain and a sensitivity of 100% for uterine adenomyosis, 100% for ovaric endometrioma, 83% for deep pelvic endometriosis and 80% for pelvic adhension

Conclusion

MR imaging is a sensitive and non invasive test in the identification of the origin of chronic pelvic pain.

References

APGO Educational Series on Women’s Health Issues. Chronic pelvic pain: an integrated approach. Crofton, Md: APGO, January 2000.Harris RD, Holtzman SR, Poppe AM. Clinical outcome in female patients with pelvic pain and normal pelvic US findings. Radiology 2000; 216: 440– 443.Kuligowska E, Deeds L, Lu K. Pelvic Pain: Overlooked and Undiagnosed gynecologic conditions. Radiographics 2005; 25: 3-20.Hottat N, Larrouse C, Anaf V, Noel JC, Matos C, Absil J, Metens T. Endometriosis: contribution of 3.0T Pelvic MR imaging I preoperative assessmentinitial results. Radiology 2009; 253: 126-134.Francica... Personal Information Pasquale Paolantonio M.D. Research Fellow; Department of Radiological Sciences, University of Rome Sapienza – Polo Pontino – C.so della Repubblica 75, Latina.Current affiliation: Azienda Ospedaliera San Giovanni-Addolorata, Rome.E-mail: [email protected]

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chronic_pelvic_pain

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