Efficiency of MR imaging to orientate surgical treatment of posterior deep pelvic endometriosis.
OBJECTIVE
The purpose of this retrospective study was to evaluate the accuracy of MRI using pelvic-phased-array and endocavitary coils in detecting intestinal wall invasion by an endometriotic nodule.


METHODS
Forty-seven patients (32.1 +/- 4.2 years) who were planned for a surgical cure of deep endometriosis underwent MRI with conventional sequences using both coils. A thin bright layer on T(2)-w with enhancement on post-Gd T(1)-w defined our MR pattern for muscular layer involvement. MR results were correlated with surgical and pathological findings of the removed nodule.


RESULTS
MR results for Group 1 (both coils) achieved a sensitivity, specificity, positive predictive value, negative predictive value, and accuracy of 100-63%, 96-92%, 90-70%, 100-85%, and 97-83% for endovaginal coil and phased-array coil, respectively. Group 2 (phased-array coil) had a sensitivity, specificity, positive predictive value, negative predictive value, and accuracy of 73%, 93%, 84%, 88%, and 87% for this coil, respectively.


CONCLUSIONS
Combined pelvic-phased-array and endovaginal coils are better than phased array alone in the detection of intestinal wall invasion. Easy to perform, it has to be considered as a preoperative staging for deep posterior endometriosis to orientate the surgical management.
Roy
Catherine
C
Department of Radiology B, Universitary Hospital of Strasbourg-Civil Hospital, 1, place de l'hopital BP 426, 67091, Strasbourg Cedex, France. catherine.roy@chru-strasbourg.fr
Balzan
Céline
C
Thoma
Véronique
V
Sauer
Benoit
B
Wattiez
Arnaud
A
Leroy
Joel
J
D000328:Adult; D004715:Endometriosis / Q000175:diagnosis* / Q000473:pathology / Q000601:surgery; D005260:Female; D006801:Humans; D007091:Image Processing, Computer-Assisted; D007410:Intestinal Diseases / Q000175:diagnosis* / Q000473:pathology / Q000601:surgery; D008279:Magnetic Resonance Imaging; D012189:Retrospective Studies; D012680:Sensitivity and Specificity