Diagnosis of pelvic endometriosis by magnetic resonance imaging using "fat-saturation" technique.
OBJECTIVE
To assess the usefulness of fat-saturated magnetic resonance (MR) imaging for detecting small endometrial implants.


METHODS
Prospective evaluation by conventional and fat-saturated MR imaging.


METHODS
Shimane Medical University Hospital, Izumo, Japan.


METHODS
Fifty-one consecutive patients with clinically suspected pelvic endometriosis.


METHODS
Magnetic resonance images < 2 weeks before laparoscopy or laparotomy.


METHODS
The location, number, and size of lesions.


RESULTS
Surgery revealed a normal pelvis in 5 patients, endometriosis in 44 (42 with pigmented lesions and 2 with nonpigmented lesions and adhesions), and other cystic lesions in 2. With fat-saturated MR imaging, overall sensitivity, specificity, positive predictive value, and negative predictive value were 89%, 71%, 95%, and 50%, respectively. At surgery, 122 pigmented lesions of endometriosis were detected. Conventional MR images indicated lesions of endometriosis in 74. When fat-saturated images were used, 103 lesions were detected. With conventional MR images, only one of 34 small endometrial implants (2 to 3 mm in diameter) was detected. However, the addition of fat-saturated images increased the detection rate to 15 of 34, and all lesions > 4 mm in diameter.


CONCLUSIONS
Conventional MR imaging for detecting small endometrial implants was improved by addition of the fat-saturation technique. Therefore, fat-saturation MR imaging is an acceptable for detecting small endometriomas.
Takahashi
K
K
Department of Obstetrics and Gynecology, Shimane Medical University, Izumo, Japan.
Okada
S
S
Ozaki
T
T
Kitao
M
M
Sugimura
K
K
D000273:Adipose Tissue; D000328:Adult; D004715:Endometriosis / Q000175:diagnosis* / Q000473:pathology / Q000601:surgery; D005260:Female; D006801:Humans; D010535:Laparoscopy; D007813:Laparotomy; D008055:Lipids; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008875:Middle Aged; D010049:Ovarian Diseases / Q000175:diagnosis / Q000473:pathology; D010388:Pelvis; D011446:Prospective Studies
D008055:Lipids