Marc Bazot MD, Presenter: Nothing to Disclose

Emile Darai, Abstract Co-Author: Nothing to Disclose

Isabelle Thomassin-Naggara, Abstract Co-Author: Nothing to Disclose

Laurent Combescure, Abstract Co-Author: Nothing to Disclose

Annie Cortez, Abstract Co-Author: Nothing to Disclose

Claude Jacques Marsault MD, Abstract Co-Author: Nothing to Disclose

To compare the accuracy of transvaginal sonography (TVS) and MR imaging (MRI) in the diagnosis of deep pelvic endometriosis (DPE), and to compare the results with surgical and pathologic findings.

Longitudinal study of 182 consecutive patients referred for surgical management of pelvic endometriosis, who underwent preoperative TVS and MRI. Diagnosis was based on TVS and MRI by the visualization of hypoechoic or hypointense areas with or without cystic cysts or hyperintense spots on T1- or T2-weighted images in specific locations (uterosacral ligaments, vagina, intestines, bladder). Sensitivity, specificity, predictive values, and accuracy of both TVS and MRI for prediction of endometriosis were assessed.

The prevalence of DPE was 71.4% (130/182). The sensitivity, specificity, and positive and negative predictive values of TVS and MRI for the diagnosis of DPE were 80 and 90.8%, 88.4 and 82.4%, 94.5 and 92.9%, and 63.9 and 77.8%, respectively. The sensitivity, specificity, and positive and negative predictive values of TVS and MRI for the diagnosis of uterosacral endometriosis (USL) were 71.2 and 78.4%, 83% and 77.5%, 86.8 and 84.4%, and 64.8 and 69.6%, respectively. The sensitivity, specificity, and positive and negative predictive values of TVS and MR imaging for the diagnosis of intestinal endometriosis were 87.2 and 87.2%, 95.2 and 96.2%, 93.2 and 94.4%, and 90.8 and 90.9%, respectively.

TVS was as accurate than MRI in the diagnosis of DPE and intestinal endometriosis. However, TVS remains low sensitive than MRI for the diagnosis of USL, vaginal or bladder endometriosis.

TVS is the first-line imaging technique for the diagnosis of pelvic endometriosis. However MRI remains the most accurate technique for overall accuracy of pelvic deep pelvic endometriosis

Bazot, M, Darai, E, Thomassin-Naggara, I, Combescure, L, Cortez, A, Marsault, C, Deep Pelvic Endometriosis: Comparison of Transvaginal Sonography and MR Imaging with Surgical and Pathologic Correlation.  Radiological Society of North America 2006 Scientific Assembly and Annual Meeting, November 26 - December 1, 2006 ,Chicago IL. http://archive.rsna.org/2006/4430544.html