Magnetic Resonance Enterography to Assess Multifocal and Multicentric Bowel Endometriosis

Krystel Nyangoh Timoh, Nyangoh Timoh K, Zelda Stewart, Stewart Z, Benjoar M, Mikhael Benjoar, Beldjord S, Selma Beldjord, Marcos Ballester, Ballester M, Marc Bazot, Bazot M, Isabelle Thomassin‐Naggara, Isabelle Thomassin-Naggara, Thomassin-Naggara I, Emile Darai, Darai E, Émile Daraï
Journal of minimally invasive gynecology · 2017 · vol. 25(4) , pp. 697–705 · doi:10.1016/j.jmig.2017.10.037 · PMID:29158158 · W2769126463
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This study utilized magnetic resonance enterography to assess the effectiveness of this imaging technique in identifying multifocal and multicentric bowel endometriosis.

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Abstract

Study objectiveTo prospectively determine the accuracy of magnetic resonance enterography (MRE) compared with conventional magnetic resonance imaging (MRI) for multifocal (i.e., multiple lesions affecting the same digestive segment) and multicentric (i.e., multiple lesions affecting several digestive segments) bowel endometriosis.DesignA prospective study (Canadian Task Force classification II-2).SettingTenon University Hospital, Paris, France.PatientsPatients with MRI-suspected colorectal endometriosis scheduled for colorectal resection from April 2014 to February 2016 were included.InterventionsPatients underwent both 1.5-Tesla MRI and MRE as well as laparoscopically assisted and open colorectal resections.Measurements and main resultsThe diagnostic performance of MRI and MRE was evaluated for sensitivity, specificity, positive and negative predictive values, accuracy, and positive and negative likelihood ratios (LRs). The interobserver variability of the experienced and junior radiologists was quantified using weighted statistics. Forty-seven patients were included. Twenty-two (46.8%) patients had unifocal lesions, 14 (30%) had multifocal lesions, and 11 (23.4%) had multicentric lesions. The sensitivity, specificity, positive LR, and negative LR for the diagnosis of multifocal lesions were 0.29 (6/21), 1.00 (23/24), 15.36, and 0.71 for MRI and 0.57 (12/21), 0.89 (23/25), 4.95, and 0.58 for MRE. The sensitivity, specificity, positive LR, and negative LR for the diagnosis of multicentric lesions were 0.18 (1/11), 1.00 (1/1), 15, and 0.80 for MRI and 0.46 (5/11), 0.92 (33/36), 5.45, and 0.60 for MRE. Lower accuracies for MRI compared with MRE to diagnose multicentric (p = .01) and multifocal lesions (p = .004) were noted. The interobserver agreement for MRE was good for both multifocality (κ = 0.80) and multicentricity (κ = 0.61).ConclusionMRE has better accuracy for diagnosing multifocal and multicentric bowel endometriosis than conventional MRI.

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Condition tags

endometriosisbowel_endometriosis

MeSH descriptors

Colonic Diseases Endometriosis Magnetic Resonance Imaging Rectal Diseases Adult Colonic Diseases Colonic Diseases Contrast Media Endometriosis Endometriosis Female Gadolinium Humans Likelihood Functions Magnetic Resonance Imaging Middle Aged Prospective Studies Rectal Diseases Rectal Diseases Sensitivity and Specificity

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