The Correlation of MRI and Laparoscopy in Evaluation of Deep Infiltrating Endometriosis

Irina Trofimenko
2013 · doi:10.1594/ecr2013/c-0462 · W2522840812
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This study evaluated the correlation between magnetic resonance imaging and laparoscopy for assessing deep infiltrating endometriosis.

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This retrospective study evaluated the diagnostic accuracy of high-resolution MRI in assessing deep infiltrating endometriosis by comparing imaging findings with laparoscopic results in 187 female patients. The MRI protocol utilized T2-weighted images, fat-suppressed T1-weighted sequences, and diffusion-weighted imaging without contrast to identify fibrotic tissue characteristics such as low T2 signal intensity and hemorrhagic foci. The authors found that MRI demonstrated good correlation with surgical observations, establishing it as an accurate method for detecting disease extent and aiding pre-surgical planning. This paper is centrally about endometriosis — specifically the radiological evaluation and diagnosis of deep infiltrating lesions using magnetic resonance imaging.

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Abstract

Poster: ECR 2013 / C-0462 / The Correlation of MRI and Laparoscopy in Evaluation of Deep Infiltrating Endometriosis by: I. Trofimenko1, D. Pavlov2, T. Bergen3, K. S. Petrov4; 1St. Petersburg/RU, 2St.Peterburg/RU, 3Novosibirsk/RU, 4Saint-Petersburg/RU
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Keywords

MR, Genital / Reproductive system female, Diagnostic procedure, Image verification Authors: I. Trofimenko1, D. Pavlov2, T. Bergen3, K. S. Petrov4; 1St. Petersburg/RU, 2St.Peterburg/RU, 3Novosibirsk/RU, 4Saint-Petersburg/RU DOI: 10.1594/ecr2013/C-0462 Purpose The purpose of the following study was to evaluate the accuracy of MRI with high in-plane resolution images in assessment of deep infiltrating endometriosis (DIE).

Methods

and Materials We performed retrospective review of 187 female patients (aged 23-45 y.o.), comparing MR images (1,5 T system) with laparoscopic findings. In all the cases surgery were performed no longer than 3 weeks after imaging. MR protocol included T2-WI in 3 standard planes with in-plane resolution 0,8х0,8 mm, slice thickness 3 mm; T1-WI with and without fat suppression and DWI with maximum b-value 800 s\mm2. All the patients obtained peristalsis inhibitor in standard dose prior the examination. Contrast enhancement was not used.

Results

The following locations of endometriosis were assessed: ovaries (n=108), retrocervical space isolated (n=18), retrocervical space with sacro-uterine ligaments (n=32), retrocervical space with contact involvement of uterus (n=62), retrocervical space with contact involvement of rectum or sigmoid (n=48), vesico-uterine space and bladder (n=17), vagina (n=9), pelvic ureters (n=5). DIE appeared as fibrotic tissue with negative mass-effect with distortion of pelvic organs and peritoneal folds; it showed predominantly low signal intensity at T2-WI with cystic cavities and haemorhagic foci (high signal intensity at T1-WI with fat suppression)....

Conclusion

MRI shows good correlation with laparoscopy and can be used as accurate method of detection and pre-surgical evaluation of deep infiltrating endometriosis.

References

Bazot M. et al. Deep pelvic endometriosis: MR imaging for diagnosis and prediction of extension of disease. Radiology 2004; 232:379-389 Cornillie F.J. et al. Deeply infiltrating pelvic endometriosis: histology and clinical significance. Fertil Steril 1990; 53:978–983. Bis K.G. et al. Pelvic endometriosis: MR imaging spectrum with laparoscopic correlation and diagnostic pitfalls. RadioGraphics 1997; 17:639–655. Gougoutas C.A, et al. Pelvic endometriosis: various manifestations and MR imaging findings. AJR Am J Roentgenol 2000; 175:353–358. Siegelman E.S. et al. Solid pelvic masses caused by endometriosis: MR imaging features....

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endometriosisdie_deep_infiltrating

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