Deep pelvic endometriosis: MR colonography increases the detection of colorectal involvement

Congress:

ECR 2010

Poster Number:

C-1295

Type:

Scientific Exhibit

Keywords:

Genital / Reproductive system female, Obstetrics (Pregnancy / birth / postnatal period), Pelvis

Authors:

A. Scardapane, S. Bettocchi, M. Lasciarrea, F. Lorusso, A. A. A. Stabile Ianora, M. Moschetta, G. Angelelli; Bari/IT

DOI:

10.1594/ecr2010/C-1295

DOI-Link:

https://dx.doi.org/10.1594/ecr2010/C-1295

Fig. 1: Fig. 1: Deep pelvic endometriosis. Pelvic MRI a) axial T1w section, b) axial...

Fig. 2: Fig.2. Deep Pelvic endometriosis. a) axial T1w section, b) axial T2w section,...

Fig. 3: Fig.3 Deep pelvic endometriosis. a) axial T1w section, b) axial T2w section, c)...

Purpose

To compare the accuracy of pelvic MRI and MR colonography (MRC) in the detection of colorectal endometriosis.

Methods and Materials

Sixty-one consecutive women with suspicion of endometriosis underwent pelvic MRI which was completed with contrast enhanced MRC. MRI and MRC were considered as two dataset which were independently reviewed by two radiologists respectively with 3 years (R1) and 10 years (R2) experience. The presence of ovarian endometriomas, pelvic nodules, Douglas obliteration, and colorectal nodules were recorded. MR findings were correlate to laparoscopy in all the cases.

Results

Sixty-five endometriomas were found in 56/61 patients (size 0,5-70 mm, mean 2,8 mm) by both the radiologists. Pelvic nodule were found in 16 women, while an obliterated douglas pouch was shown in 9 patients by R1 and R2. Colorectal involvement was diagnosed at pelvic MRI in 4/61 cases by R1 and in 9/61 cases by R2 (k= 0,57). Using MRC, colorectal involvement was shown in 10/61 cases and 11/61 cases respectively (K=0,94). Laparoscopy demonstrated the presence of colorectal involvement in 13/61 with no false positive...

Conclusion

The combinations of pelvic MRI and MRC increases the sensitivity and NPV in the detection of colorectal endometriosis. Moreover an higher interobserver agreement is achieved using MRC compared with pelvic MRI.

References

1. Bazot M, Darai E, Hourani R, Thomassin I, Cortez A, Uzan S, et al. Deep pelvic endometriosis: MR imaging for diagnosis and prediction of extension of disease. Radiology. 2004 ;232(2):379-89.2. Belaisch J. Endometriosis: is laparoscopy justified without previous ultrasonogram and magnetic resonance imaging (MRI)?. Fertility and sterility. 2010. DOI: 10.1016/j.fertnstert.2009.11.0263. Biscaldi E, Ferrero S, Fulcheri E, Ragni N, Remorgida V, Rollandi GA. Multislice CT enteroclysis in the diagnosis of bowel endometriosis. European radiology. 2007 ;17(1):211-9.4. Chamié LP, Blasbalg R, Gonçalves MO, Carvalho FM, Abrão...