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Comparison of routine pelvic US and MR imaging in patients with pathologically confirmed endometriosis

  • David J. Bartlett
  • Brian J. Burkett
  • Tatnai L. Burnett
  • Shannon P. Sheedy
  • Joel G. Fletcher
  • Wendaline M. VanBurenEmail author
Special Section: Endometriosis

Abstract

Purpose

To estimate the benefit of pelvic magnetic resonance (MR) imaging after routine pelvic ultrasound (US) in patients with pathologically or surgically proven endometriosis.

Methods

Patients with surgically or pathologically proven endometriosis who had routine pelvic US followed by pelvic MR within 6 months prior to surgery were included. Patients were excluded if they had previously confirmed endometriosis, pregnancy, or surgery > 6 months after MR. The detection rate of endometriosis by pelvic US and MR was compared to the surgical/pathological reference standard.

Results

83 female patients (mean age 40 ± 9) met inclusion criteria and had surgical/pathological confirmation of endometriosis. The mean time interval between pelvic US and MR was 33 ± 43 days, with 64 ± 69 days between MR examination and surgery. US detected endometriosis in 22% (18/83) of patients compared to 61% (51/83) for MR (p < 0.0001). 51% (33/65) of patients with a negative pelvic US exam had a positive MR. MR identified additional sites or sequela in the majority of patients with a positive US (14/18; 78%), including extraovarian locations [e.g., fallopian tubes 7/18 (39%), uterus 7/18 (39%), uterine ligaments 6/18 (33%), posterior cul de sac 5/18 (28%), pelvic side walls 5/18 (28%), abdominal wall 1/18 (6%)] and sequela [ovarian tethering 5/18 (28%), 6/18 (33%) bowel adhesive disease, posterior cul de sac obliteration 2/18 (11%), hydrosalpinx 2/18 (11%), and hydronephrosis 1/18 (6%)]. 3 T MR detected endometriosis in 33/46 (72%) patients compared to 18/37 (49%) for 1.5 T MR (p = 0.03).

Conclusion

Pelvic MR imaging had a higher detection rate of surgically/pathologically proven endometriosis and provides more information about disease location and sequela compared to routine pelvic US.

Keywords

Endometriosis Magnetic resonance imaging (MRI) Ultrasound Women’s health Radiology Gynecology 

Notes

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Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2019

Authors and Affiliations

  • David J. Bartlett
    • 1
  • Brian J. Burkett
    • 1
  • Tatnai L. Burnett
    • 2
  • Shannon P. Sheedy
    • 1
  • Joel G. Fletcher
    • 1
  • Wendaline M. VanBuren
    • 1
    Email author
  1. 1.Department of RadiologyMayo ClinicRochesterUSA
  2. 2.Department of Obstetrics and GynecologyMayo ClinicRochesterUSA

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