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The IDEAL study: MRI for suspected deep endometriosis assessment prior to laparoscopy is equally reliable as radiological imaging as a complement to transvaginal ultrasonography
- Publication Year :
- 2019
- Publisher :
- Wiley, 2019.
-
Abstract
- OBJECTIVES: this prospective observational study compared the value of magnetic resonance imaging (MRI) complementary to transvaginal ultrasonography (TV-US) to our standard preoperative assessment of patients with endometriosis referred for surgery in a tertiary care academic center. Based on the extent to which endometriosis affects reproductive organs, bowel, ureters, bladder or other abdominal organs, the surgery will be carried out by gynecologists only or by a multidisciplinary team involving abdominal surgeons and/or urologists. METHODS: In 74 women with clinically suspected deep endometriosis (DE) the standard preoperative imaging, i.e. an expert transvaginal ultrasonography (TV-US), complemented by an intravenous urography (IVU) for the evaluation of the ureters, and a double contrast barium enema (DCBE) for the evaluation of the rectum, sigmoid and caecum was compared with an expert TV-US complemented by a 'one-stop' abdominal and pelvic magnetic resonance imaging (MRI). The findings of the laparoscopy were the reference standard to provide an answer to the question if a 'one-stop' abdominal/pelvic MRI is equally reliable as our standard radiological imaging as a complement to transvaginal ultrasonography for preoperative triaging of patients with suspected urological and intestinal involvement by DE in tertiary care centers. RESULTS: The standard preoperative imaging as well as the combined findings of the TV-US and the MRI allowed a correct stratification for a monodisciplinary approach by gynecologists or a multidisciplinary approach in 90.5% of the patients. Both TV-US and DCBE underestimated the severity of the rectal involvement in 2.7%, whereas TV-US and/or DCBE overestimated it in 6.8% of the patients. CONCLUSIONS: In conclusion, complementary to an expert transvaginal ultrasound (TV-US) a 'one-stop' magnetic resonance imaging (MRI) predicts the intra-operative findings equally well as the standard radiological imaging (IVU and DCBE) in patients referred for endometriosis surgery in a tertiary care academic center.
- Subjects :
- Technology
Deep endometriosis (DE)
magnetic resonance imaging (MRI)
SLIDING SIGN
ACCURACY
deep endometriosis
laparoscopy
intravenous urography (IVU)
TVS
double contrast barium enema
double contrast barium enema (DCBE)
transvaginal ultrasonography (TV-US)
intravenous urography
DIAGNOSTIC-VALUE
RECTOSIGMOID ENDOMETRIOSIS
INFILTRATING ENDOMETRIOSIS
MRI FINDINGS
CLINICAL EXAMINATION
Obstetrics & Reproductive Medicine
RECTAL-CANCER
Science & Technology
Radiology, Nuclear Medicine & Medical Imaging
Obstetrics & Gynecology
Acoustics
tertiary care centers
EUROPEAN-SOCIETY
PELVIC ENDOMETRIOSIS
1114 Paediatrics and Reproductive Medicine
bowel endometriosis
Life Sciences & Biomedicine
MRI
Subjects
Details
- Language :
- English
- Database :
- OpenAIRE
- Accession number :
- edsair.od......1032..40b698fa22a7bc1ec83b2b122be46718