Journal of South Asian Federation of Obstetrics and Gynaecology

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VOLUME 14 , ISSUE 2 ( March-April, 2022 ) > List of Articles

Original Article

Comparison between Ultrasonography and Magnetic Resonance Imaging in Endometriosis: A Prospective Study in a Tertiary Hospital

Sulabh Puri, Ashima Gupta, Gurpreet S Sandhu, Jaswinder K Mohi

Citation Information : Puri S, Gupta A, Sandhu GS, Mohi JK. Comparison between Ultrasonography and Magnetic Resonance Imaging in Endometriosis: A Prospective Study in a Tertiary Hospital. J South Asian Feder Obs Gynae 2022; 14 (2):85-90.

DOI: 10.5005/jp-journals-10006-2011

License: CC BY-NC 4.0

Published Online: 21-06-2022

Copyright Statement:  Copyright © 2022; The Author(s).


Abstract

Introduction: Endometriosis is an important cause for abdominal and pelvic pain in young women. It occurs due to the presence of functional endometrial tissue outside the uterine cavity. Ultrasonography and magnetic resonance imaging (MRI) are noninvasive and accurate diagnostic modalities for evaluation of ovarian and deep endometriosis. Aim: To compare and assess the diagnostic accuracy of ultrasonography and MRI for evaluation of endometriosis. Materials and methods: A prospective study was done on 40 patients sent to the radiology department in our tertiary-care hospital over a period of 2 years with clinical suspicion of endometriosis. These patients were evaluated on ultrasonography, followed by MRI scan for the location and extent of disease. The sensitivity and specificity of diagnostic modalities were calculated. Results: The sensitivity and specificity of ultrasound for diagnosing ovarian endometriosis (endometriomas) were 90.62 and 75.00%, respectively, and that of MRI were 93.94 and 85.71%, respectively. The sensitivity and specificity of ultrasound for diagnosing deep endometriosis (involving uterosacral ligament) were 25 and 97.30%, respectively, and that of MRI were 75.0 and 100%, respectively. The sensitivity and specificity of ultrasound for diagnosing scar endometriosis were 66.67 and 97.30%, respectively, and that of MRI were each 100%, respectively. The sensitivity and specificity of ultrasound for diagnosing tubal endometriosis were 50.00 and 97.37%, respectively, and that of MRI were each 100%, respectively. The findings of ultrasonography and MRI for evaluation of endometriosis were also correlated with histopathology. Conclusion: Both ultrasonography and MRI are comparable modalities for evaluation of ovarian, scar site, and tubal endometriosis; however, MRI is the most useful and better imaging modality for evaluation of indeterminate cases and deep endometriosis.


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  1. Alimi Y, Iwanaga J, Loukas M, et al. The clinical anatomy of endometriosis: a review. Cureus 2018;10(9). DOI: 10.7759/cureus.3361.
  2. Giudice LC, Kao LC. Endometriosis. Lancet 2004;364(9447):1789–1799. DOI: 10.1016/S0140-6736(04)17403-5.
  3. TACoOa G. Practice bulletin no. 114: management of endometriosis. Obstet Gynecol 2010;116(1):223–236. DOI: 10.1097/AOG.0b013e3181e8b073.
  4. Nnoaham KE, Webster P, Kumbang J, et al. Is early age at menarche a risk fac-tor for endometriosis? A systematic review and meta-analysis of case-control studies. Fertil Steril 2012;98(3):702–712. DOI: 10.1016/j.fertnstert.2012.05.035.
  5. Sourial S, Tempest N, Hapangama DK. Theories on the pathogenesis of endometriosis. Int J Reprod Med 2014;2014:179515. DOI: 10.1155/2014/179515.
  6. Foti PV, Farina R, Palmucci S, et al. Endometriosis: clinical features, MR imaging findings and pathologic correlation. Insights Imaging 2018;9(2):149–172. DOI: 10.1007/s13244-017-0591-0.
  7. Rolla E. Endometriosis: advances and controversies in classification, pathogenesis, diagnosis, and treatment. F1000Res 2019;8:F1000 Faculty Rev-529. DOI: 10.12688/f1000research.14817.1.
  8. Halis G, Mechsner S, Ebert AD. The diagnosis and treatment of deep infiltrating endometriosis. Deutsch Arztebl Int 2010;107(25):446. DOI: 10.3238/arztebl.2010.0446.
  9. Jha P, Sakala M, Chamie LP, et al. Endometriosis MRI lexicon: consensus statement from the society of abdominal radiology endometriosis disease-focused panel. Abdom Radiol 2019;45(6):1–17. DOI: 10.1007/s00261-019-02291-x.
  10. Kruger K, Behrendt K, Niedobitek-Kreuter G, et al. Location-dependent value of pelvic MRI in the preoperative diagnosis of endometriosis. Eur J Obstet Gynecol Reprod Biol 2013;169(1):93–98. DOI: 10.1016/j.ejogrb.2013.02.007.
  11. Glastonbury CM. The shading sign. Radiology 2002;224(1):199–201. DOI: 10.1148/radiol.2241010361.
  12. Guerriero S, Ajossa S, Minguez J, et al. Accuracy of transvaginal ultrasound for diagnosis of deep endometriosis in uterosacral ligaments, rectovaginal septum, vagina and bladder: systematic review and meta-analysis. Ultrasound Obstet Gynecol 2015;46(5):534–545. DOI: 10.1002/uog.15667.
  13. Teh J, Leung J, Dhar S, et al. Abdominal wall endometriosis: comparative imaging on power Doppler ultrasound and MRI. Clin Radiol Extra 2004;59(8):74–77. DOI: 10.1016/j.cradex.2004.02.004.
  14. Tadros MY, Keriakos NN. Diffusion MRI versus ultrasound in superficial and deep endometriosis. Egypt J Radiol Nucl Med 2016;47(4): 1765–1771. DOI: 10.1016/j.ejrnm.2016.07.011.
  15. Takeuchi M, Matsuzaki K, Nishitani H. Susceptibility-weighted MRI of endometrioma: preliminary results. Am J Roetgenol 2008;191(5):1366–1370. DOI: 10.2214/AJR.07.3974.
  16. Chamie LP, Blasbalg R, Pereira RMA, et al. Findings of pelvic endometriosis at transvagi-nal US, MR imaging, and laparoscopy. Radiographics 2011;31(4):E77–E100. DOI: 10.1148/rg.314105193.
  17. Asch E, Levine D. Variations in appearance of endometriomas. J Ultrasound Med 2007;26(8):993–1002. DOI: 10.7863/jum.2007.26.8.993.
  18. Collins BG, Ankola A, Gola S, et al. Transvaginal US of endometriosis: looking beyond the endometrioma with a dedicated protocol. RadioGraphics 2019;39(5):1549–1568. DOI: 10.1148/rg.2019190045.
  19. Imaoka I, Wada A, Matsuo M, et al. MR imaging of disorders associated withfemale infertility: use in diagnosis, treatment, and management. Radiographics 2003;23(6):1401–1414. DOI: 10.1148/rg.236025115.
  20. Nardo LG, Pea SD, Gryparis I. Endometriosis of the ovary. Karolinska Institut et University Library; 2019. p. 189–197.
  21. Corwin MT, Gerscovich EO, Lamba R, et al. Differentiation of ovarian endometrium as from hemorrhagic cysts at MR imaging: utility of the T2 dark spot sign. Radiology 2014;271(1):126–132. DOI: 10.1148/radiol.13131394.
  22. Nisenblat V, Bossuyt PM, Farquhar C, et al. Imaging modalities for the non-invasive diagnosis of endometriosis. Cochrane Database Syst Rev 2016;2(2):CD009591. DOI: 10.1002/14651858. CD009591.pub2.
  23. Indrielle-Kelly T, Fruhauf F, Fanta M, et al. Diagnostic accuracy of ultrasound and MRI in the mapping of deep pelvic endometriosis using the international deep endometriosis analysis (IDEA) consensus. BioMed Res Int 2020;2020. DOI: 10.1155/2020/3583989.
  24. Hansen JH, Van Breda Vriesman AC, Puylaert JB. Abdominal wall endometriosis: clinical presentation and imaging features with emphasis on sonography. AJR 2006;186(3):616–620. DOI: 10.2214/AJR.04.1619.
  25. Kotdawala KP, Agrawal M, Ambatkar V. Scar endometriosis: a case report of a rare complication of laparotomy for ectopic pregnancy. J South Asian Feder Obst Gynae 2021;13(1):68–70. DOI: 10.5005/jp-journals-10006-1866.
  26. Balleyguier C, Chaperon C, Chopin N, et al. Abdominal wall and surgical scar endometriosis: results of magnetic resonance imaging. Gynecol Obstet Invest 2003;55(4):220–224. DOI: 10.1159/000072078.
  27. Patel BS, Tripathi JB, Patel FB, et al. Extrapelvic endometriosis: a study of 17 cases. J South Asian Feder Obst Gynae 2012;4(1):32–34. DOI: 10.5005/jp-journals-10006-1168.
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