Pemanfaatan MRI Pelvis untuk Memprediksi Kedalaman Infiltrasi Endometriosis Susukan dalam Posterior ke Rektosigmoid: Studi Komparasi

Yustie Amelia, Refni Muslim, M. Luky Satria Marwali, Bonita Prawirodihardjo, Joedo Prihartono
In: Journal Of The Indonesian Medical Association · 2019 · vol. 69(4) , pp. 170–177 · doi:10.47830/jinma-vol.69.4-2019-64 · W3108966033
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⚙ AI-generated summary by claude@2026-06, 2026-06-06 ⓘ

This study compared pelvic MRI findings to surgical and histopathological results in 37 patients to assess MRI's accuracy in predicting deep posterior rectosigmoid endometriosis infiltration depth.

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⚙ AI-generated deep summary by claude@2026-07, 2026-07-15 · read from full text ⓘ

This retrospective comparative study evaluated whether pelvic MRI could predict the depth of posterior deep infiltrating endometriosis (DIE) infiltration into the rectosigmoid, using surgical reports and histopathology as reference standards. Thirty-seven patients who underwent both pelvic MRI and subsequent surgery for posterior DIE (2015–2018) had MRI images independently analyzed by a gynecology radiologist and then compared with operative and pathological findings. The results showed very high concordance for assessing rectosigmoid extension, with similarly high concordance for infiltration into the muscular layer, while concordance for (sub)mucosal layer infiltration was lower and not consistently significant. This paper is centrally about endometriosis—specifically using pelvic MRI to predict the depth of rectosigmoid infiltration in posterior deep infiltrating endometriosis.

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Abstract

Pendahuluan: Infiltrasi endometriosis susukan dalam (ESD) posterior ke rektosigmoid sering memerlukan tata laksana pembedahan radikal dan lintas disiplin. Modalitas diagnostik standar seperti USG dan laparaskopi lemah dalam menilai infiltrasi ESD posterior di lokasi yang sulit terjangkau. MRI berpotensi menjadi modalitas diagnostik pilihan karena bersifat multiplanar dan baik dalam diferensiasi jaringan lunak. Penelitian ini bertujuan membandingkan kesesuaian MRI pelvis dengan temuan operasi dan histopatologi untuk memprediksi kedalaman infiltrasi ESD posterior ke rektosigmoid. Metode: Sebanyak 37 pasien yang menjalani operasi dengan indikasi ESD posterior dan pemeriksaan MRI pelvis di pusat rujukan endometriosis (2015-2018) dipelajari secara retrospektif. Gambar MRI dianalisis oleh dokter spesialis radiologi divisi ginekologi secara independen kemudian dibandingkan dengan laporan operasi dan analisis sediaan histopatologi oleh dokter spesialis patologi anatomi. Analisis statistik dilakukan menggunakan uji McNemar dan koefisien Cohen’s Kappa. Hasil: Didapatkan nilai konkordan (McNemar p) dan koefisien Kappa (p) untuk penilaian adanya ekstensi ESD posterior ke rektosigmoid 100% (1,000) dan 1 (0,000); infiltrasi lapisan muskularis rektosigmoid 89,2% (0,617) dan 0,78 (0,001); infiltrasi lapisan submukosa rektosigmoid 81,1% (1,000) dan 0,35 (0,146). Kesimpulan: Terdapat kesesuaian yang baik antara MRI pelvis dengan temuan operasi dan histopatologi dalam memprediksi kedalaman infiltrasi ESD posterior ke rektosigmoid.
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Abstract

Introduction: Rectosigmoid infiltration in posterior deep infiltrating en-dometriosis (DIE) requires radical and interdisciplinary surgery. Standard di-agnostic modalities such as ultrasound and laparoscopy are weak in assesingposterior DIE infiltration to inaccessible areas. MRI has the potential value tobe modality of choice because it is multiplanar and excellent in soft tissuedifferentiation. This study aimed to compare pelvic MRI with surgical findingsand histopathology to predict depth of rectosigmoid infiltration in posteriorDIE.

Methods

Thirty-seven patients who underwent surgery and pelvic MRI ex-aminations for posterior DIE at the endometriosis referral center (2015-2018)were studied retrospectively. MRI images were analyzed by a gynecology ra-diologist independently then compared to the surgical report and histopatho-logical analysis. Statistical analysis was performed using the McNemar testand the Cohen’s Kappa coefficient.

Results

Concordance values (McNemar p) and Kappa coefficients (p) forassesment of rectosigmoid extension in posterior DIE were 100% (1,000) and1 (0,000); infiltration into themuscular layer of rectosigmoid were 89.2% (0.617)and 0.78 (0.001); infiltration into the (sub)mucosal layer of rectosigmoid were81.1% (1,000) and 0.35 (0.146).

Conclusion

There was good concordance between pelvic MRI and surgical-histopathologic findings to predict depth of rectosigmoid infiltration in poste-rior DIE.

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Condition tags

endometriosis

Citation neighborhood

Papers in the corpus that this work cites (lower rings, blue) and that cite this one (upper rings, green). Dot size scales with the paper's in-corpus citation count — bigger dot = more influential within the endo/adeno field. Click a dot to open that paper. [ expand to 2 hops ] — adds papers reached through this work's immediate citers/citees. Heavier; up to 60 extra dots.

References (17)

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