Rosario Francesco Grasso, Abstract Co-Author: Nothing to Disclose

Vincenza Di giacomo, Presenter: Nothing to Disclose

Pietro Sedati MD, Abstract Co-Author: Nothing to Disclose

Riccardo del Vescovo MD, Abstract Co-Author: Nothing to Disclose

Eliodoro Faiella MD, Abstract Co-Author: Nothing to Disclose

Bruno Beomonte Zobel MD, Abstract Co-Author: Nothing to Disclose

Ornella Sizzi, Abstract Co-Author: Nothing to Disclose

Giuseppe Florio, Abstract Co-Author: Nothing to Disclose

Alfonso Rossetti, Abstract Co-Author: Nothing to Disclose

et al, Abstract Co-Author: Nothing to Disclose

The aim of our study was to compare vaginal endosonography (VES) and magnetic resonance (MR) in the evaluation of deep pelvic endometriosis.

Between June 2005 and March 2007, 35 patients (median age 35) with clinical suspicious of pelvic endometriosis underwent both MR and VES before laparoscopic surgery. Histopathological examination of the resected lesions was available in all the patients. The median interval between MR, VES and laparoscopy was two weeks (range 1-4 weeks). Sensitivity, specificity, positive and negative predictive values, and accuracy of MR imaging and VES were evaluated for each site of deep pelvic endometriosis. Surgical and pathological findings were used as standard of reference. The kappa Cohen values and statistical significance were estimated to evaluate the agreement between VES and laparoscopy, MR and laparoscopy and VES and MR. A p value < 0,05 was considered statistically significant.  

Sensitivity, specificity, positive and negative predictive value of MR in the diagnosis of deep endometriosis were: 75%, 100%, 100%, 95,2% for bladder endometriosis; 70%, 92,1%, 70%, 70% for uterosacral ligaments; 76,9%, 100%, 100%, 78,5% for rectovaginal septum; 66,6%, 100%, 100%, 95,4% for sigmoid colon. Those of VES were: 25%, 100%, 100%, 86,9% for bladder endometriosis; 50%, 94,7%, 71,4%, 87,8% for uterosacral ligaments; 76,9%, 100%, 100%, 78,5% for rectovaginal septum; 33,3%, 100%, 100%, 91,3% for sigmoid colon.

Ultrasound is a reliable method for the diagnosis of rectovaginal septum endometriosis. However, for all the other localizations of deep pelvic endometriosis MR represents the gold standard to localize and define the exact extent of the disease and to provide a road map for the laparoscopic intervention.

The anatomic distribtion of deep pelvic endometriotic lesions determine the surgical management and approach. MR is the best diagnostic tool to provide a correct preoperative staging of this disease.

Grasso, R, Di giacomo, V, Sedati, P, del Vescovo, R, Faiella, E, Beomonte Zobel, B, Sizzi, O, Florio, G, Rossetti, A, et al, , Comparison of Magnetic Resonance Imaging and Vaginal Endosonography in the Detection of Deep Pelvic Endometriosis.  Radiological Society of North America 2008 Scientific Assembly and Annual Meeting, February 18 - February 20, 2008 ,Chicago IL. http://archive.rsna.org/2008/6017545.html