The Diagnostic Value Of MRI In Deep Infiltrating Endometriosis

Purpose:To explore the clinical value of MRI in the identification of different locations in deep infiltrating endometriosis(DIE).Methods:57 patients with histologically confirmed DIE were retrospectively studied.All the patients underwent MRI before laparoscopic surgery.Mapping of different locations in DIE was performed.MRI results were compared with surgical and pathological findings,and the diagnostic efficacy of different locations in DIE was evaluated.Results:The total sensitivity for MRI in the identification of DIE was 73.7%(42/57).Among 57 patients,the sensitivity,specificity and accuracy for MRI in the detection of DIE in retrocervical septum were 60.5%(23/38),94.7%(18/19)and 71.9%(41/57).The sensitivity,specificity and accuracy of DIE in uterosacral ligment were 47.5%(19/40),89.2%(66/74)and 74.6%(85/114).The sensitivity,specificity and accuracy of diagnosing posterior cul-de-sac obliteration and adhesion were 78.9%(15/19),76.3%(29/38)and 77.2%(44/57).The sensitivity,specificity and accuracy of bladder were 71.4%(5/7),100%(50/50)and 96.5%(55/57).The sensitivity,specificity and accuracy of rectum were 20.0%(1/5),98.1%(51/52)and 91.2%(52/57).MRI showed limitations in detecting rectum and sigmoid colon DIE lesions.Conclusion:MRI can demonstrate a high accuracy in the diagnosis of different locations of DIE,especially in the detection of cul-de-sac obliteration,assessing the diagnosis efficacy of retrocervical septum and bladder DIE,as well as evaluation the locations and extension of DIE before surgery.The information offered by MRI is helpful in determining surgical options and planning appropriate treatment.