A novel technique using magnetic resonance imaging jelly for evaluation of rectovaginal endometriosis.
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.
Takeuchi
Hiroyuki
H
Department of Obstetrics and Gynecology, Juntendo University School of Medicine, Tokyo, Japan. hirotake@med.juntendo.ac.jp
Kuwatsuru
Ryohei
R
Kitade
Mari
M
Sakurai
Akihiro
A
Kikuchi
Iwaho
I
Shimanuki
Hiroto
H
Kinoshita
Katsuyuki
K
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