The role of magnetic resonance imaging in minimal access surgery

Hugh Byrne, Byrne H, Hugh J. Byrne, Ball E, Elizabeth Ball, Colin Davis, Colin J. Davis, Davis C
Current opinion in obstetrics & gynecology · 2006 · vol. 18(4) , pp. 369–373 · doi:10.1097/01.gco.0000233928.19522.f0 · PMID:16794414 · W2087075949
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Magnetic resonance imaging shows promise in diagnosing benign gynecological conditions like endometriosis, adenomyosis, and fibroids, potentially reducing surgical morbidity when used for carefully selected preoperative patients.

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This review evaluates the utility of magnetic resonance imaging as an adjunct to minimal access surgery for various benign gynecological conditions. The authors find that while MRI is comparable to ultrasound for diagnosing fibroids and endometriosis, it may be superior for identifying adenomyosis and is particularly valuable for preoperative assessment of severe recto-vaginal disease. However, the paper notes that mild endometriosis remains difficult to detect with current imaging modalities and advises against routine first-line use due to cost-effectiveness concerns unless specific high-risk patients are selected. This paper is centrally about endometriosis and adenomyosis, specifically discussing the diagnostic accuracy and surgical planning implications of MRI for these conditions.

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Abstract

PURPOSE OF REVIEW: Magnetic resonance imaging is commonly used for gynaecological malignancies, but also is increasingly used for the investigation of benign gynaecological complaints. This review summarizes the current evidence regarding its use as an adjunct to minimal access surgery for endometriosis, adenomyosis, adhesions and fibroids. RECENT FINDINGS: Magnetic resonance imaging appears to be equal in efficacy to ultrasound for the diagnosis of both fibroids and endometriosis, and perhaps superior for the diagnosis of adenomyosis. It is extremely useful for the preoperative investigation of severe endometriosis, especially recto-vaginal disease. Milder endometriosis is, however, still difficult to diagnose by either ultrasound or magnetic resonance imaging. Magnetic resonance imaging can also be helpful for the detection of adhesions, pelvic collections, congenital defects and fibroids. It is also useful following fibroid embolization. SUMMARY: Currently, it is not cost-effective to use magnetic resonance imaging as the modality of first choice when investigating pelvic pain and or menstrual disorders. If preoperative patients are carefully selected, however, it can substantially reduce surgical morbidity by using it to diagnose severe endometriosis and adhesions which may lead to cost savings overall.
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The role of magnetic resonance imaging in minimal access surgery - Hugh Byrne - Elizabeth Ball - Colin Davis Purpose of review Magnetic resonance imaging is commonly used for gynaecological malignancies, but also is increasingly used for the investigation of benign gynaecological complaints. This review summarizes the current evidence regarding its use as an adjunct to minimal access surgery for endometriosis, adenomyosis, adhesions and fibroids. Recent findings Magnetic resonance imaging appears to be equal in efficacy to ultrasound for the diagnosis of both fibroids and endometriosis, and perhaps superior for the diagnosis of adenomyosis. It is extremely useful for the preoperative investigation of severe endometriosis, especially recto-vaginal disease. Milder endometriosis is, however, still difficult to diagnose by either ultrasound or magnetic resonance imaging. Magnetic resonance imaging can also be helpful for the detection of adhesions, pelvic collections, congenital defects and fibroids. It is also useful following fibroid embolization. Summary Currently, it is not cost-effective to use magnetic resonance imaging as the modality of first choice when investigating pelvic pain and or menstrual disorders. If preoperative patients are carefully selected, however, it can substantially reduce surgical morbidity by using it to diagnose severe endometriosis and adhesions which may lead to cost savings overall.

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Condition tags

endometriosisadenomyosis

MeSH descriptors

Magnetic Resonance Imaging Minimally Invasive Surgical Procedures Endometriosis Endometriosis Endometriosis Female Humans Leiomyoma Leiomyoma Leiomyoma Tissue Adhesions Tissue Adhesions Tissue Adhesions Uterine Neoplasms Uterine Neoplasms Uterine Neoplasms

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.

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