title: A novel technique using magnetic resonance imaging jelly for evaluation of rectovaginal endometriosis.
abstract: OBJECTIVE
  To evaluate the usefulness of the magnetic resonance imaging (MRI) jelly method as a preoperative diagnostic means for patients with rectovaginal endometriosis.
  
  
  METHODS
  Prospective study.
  
  
  METHODS
  University hospital.
  
  
  METHODS
  Thirty one patients with suspected rectovaginal endometriosis based on clinical symptoms and the results of preoperative pelvic, rectal, and ultrasonographic examinations, who were scheduled to undergo laparoscopic surgery.
  
  
  METHODS
  Before surgery, jelly for ultrasonography was injected into the vagina and rectum for MRI. The MRI findings were compared with findings obtained through laparoscopic surgery and histopathologic examination of the removed tissues.
  
  
  METHODS
  The complete cul-de-sac obliteration and deep lesion confirmed at the time of the laparoscopic surgery were evaluated by the MRI jelly method.
  
  
  RESULTS
  For detecting the presence of complete obliteration of the cul-de-sac, the accuracy of the diagnosis of rectovaginal endometriosis attained using the MRI jelly method was sensitivity 90.9% and specificity 77.8%. For the presence of a deep lesion, the sensitivity was 94.1% and specificity 100%.
  
  
  CONCLUSIONS
  The condition of the cul-de-sac could be imaged clearly via the MRI jelly method. Not only rectovaginal endometriosis presenting with deep lesions, but also complete cul-de-sac obliteration alone could be diagnosed preoperatively at a high rate.
authors.affiliation: Department of Obstetrics and Gynecology, Juntendo University School of Medicine, Tokyo, Japan. hirotake@med.juntendo.ac.jp
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Takeuchi
authors.forename: Ryohei
authors.initials: R
authors.lastname: Kuwatsuru
authors.forename: Mari
authors.initials: M
authors.lastname: Kitade
authors.forename: Akihiro
authors.initials: A
authors.lastname: Sakurai
authors.forename: Iwaho
authors.initials: I
authors.lastname: Kikuchi
authors.forename: Hiroto
authors.initials: H
authors.lastname: Shimanuki
authors.forename: Katsuyuki
authors.initials: K
authors.lastname: Kinoshita
mesh_terms: D000328:Adult; D004715:Endometriosis / Q000473:pathology* / Q000601:surgery; D005260:Female; D006801:Humans; D008153:Lubrication; D008279:Magnetic Resonance Imaging / Q000379:methods*; D011300:Preoperative Care; D011446:Prospective Studies; D012007:Rectum; D012680:Sensitivity and Specificity; D014621:Vagina