Diagnosis of deep infiltrating endometriosis: accuracy of magnetic resonance imaging and transvaginal 3D ultrasonography.
OBJECTIVE
To compare two different imaging modalities, magnetic resonance (MR), and three-dimensional sonography (3DUS), in order to evaluate the specific role in preoperative work-up of deep infiltrating endometriosis.


METHODS
33 women with endometriosis underwent 3DUS and MR followed by surgical and histopathological investigations. Investigators described the disease extension in the following sites: torus uterinus and uterosacral ligaments (USL), vagina, rectovaginal-septum, rectosigmoid, bladder, ovaries. Results were compared with surgical and histopathological findings.


RESULTS
Ovarian and deep pelvic endometriosis were found by surgery and histology in, respectively, 24 (72.7%) and 22 (66.6%) of the 33 patients. Sensitivity and specificity values of 3DUS for the diagnosis of endometrial cysts were 87.5% and 100%, respectively; those of MRI were 96.8% and 91.1%, respectively. Sensitivity and specificity of 3DUS for the diagnosis of deep infiltrating endometriosis in specific sites were: USL 50% and 94.7%; vagina 84% and 80%; rectovaginal-septum 76.9% and 100%; rectosigmoid 33.3% and 100%; bladder 25% and 100%. Those of MR were: USL 69.2% and 94.3%; vagina 83.3% and 88.8%; rectovaginal-septum 76.4% and 100%; restosigmoid 75% and 100%; bladder 83.3% and 100%.


CONCLUSIONS
MR accurately diagnoses deep infiltrating endometriosis; 3DUS accurately diagnoses deep infiltrating endometriosis in specific locations.
Grasso
Rosario Francesco
RF
Department of Diagnostic Imaging, University of Rome, Italy.
Di Giacomo
Vincenza
V
Sedati
Pietro
P
Sizzi
Ornella
O
Florio
Giuseppe
G
Faiella
Eliodoro
E
Rossetti
Alfonso
A
Del Vescovo
Riccardo
R
Zobel
Bruno Beomonte
BB
D000328:Adult; D003287:Contrast Media; D003937:Diagnosis, Differential; D004715:Endometriosis / Q000000981:diagnostic imaging* / Q000473:pathology* / Q000601:surgery; D005260:Female; D019786:Gadolinium DTPA; D006801:Humans; D021621:Imaging, Three-Dimensional; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008875:Middle Aged; D011446:Prospective Studies; D012680:Sensitivity and Specificity; D014463:Ultrasonography / Q000379:methods*; D014621:Vagina
D003287:Contrast Media; D019786:Gadolinium DTPA