Diagnostic accuracy of laparoscopy, magnetic resonance imaging, and histopathologic examination for the detection of endometriosis.
OBJECTIVE
To evaluate the utility of fat-suppressed magnetic resonance imaging (MRI) in the diagnosis of endometriosis.


METHODS
A prospective clinical trial.


METHODS
A government research hospital.


METHODS
Forty-eight women with pelvic pain.


METHODS
Magnetic resonance imaging followed by surgical excision and pathologic diagnosis of endometriosis.


METHODS
Presence and extent of endometriosis suggested by preoperative MRIs compared with surgical inspection and biopsy.


RESULTS
A preoperative MRI in 46 women detected fewer endometriosis lesions than histopathology or laparoscopy (78 vs. 101 vs. 150). Few MRI lesions correlated with those identified by laparoscopy (50 of 150) or pathology (38 of 101). Of 42 women with surgically diagnosed endometriosis, 28 had at least one corresponding abnormality on MRI, 5 had abnormalities that didn't correlate with surgical findings, and 9 had normal MRIs. The sensitivity of MRI in detecting biopsy-proven endometriosis for any woman was 69% (25 of 36), and the specificity was 75%.


CONCLUSIONS
Although MRI identifies fewer areas of endometriosis than seen at surgery, it suggested endometriosis in 75% of those with at least mild disease. Only 67% of lesions identified at surgery contained histologic evidence of endometriosis.
Pediatric and Reproductive Endocrinology Branch, National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, Maryland 20892, USA. ps79c@nih.gov
Pamela
P
Stratton
Craig
C
Winkel
Ahalya
A
Premkumar
Catherine
C
Chow
Jan
J
Wilson
Rhonda
R
Hearns-Stokes
Sunyeong
S
Heo
Maria
M
Merino
Lynnette K
LK
Nieman
D000328:Adult; D004311:Double-Blind Method; D004715:Endometriosis / Q000175:diagnosis* / Q000473:pathology / Q000601:surgery; D005260:Female; D006801:Humans; D010535:Laparoscopy; D008279:Magnetic Resonance Imaging; D011446:Prospective Studies