Valeria Fiaschetti MD, PhD, Abstract Co-Author: Nothing to Disclose

Sonia Crusco MD, Abstract Co-Author: Nothing to Disclose

Valentina Cama MD, Presenter: Nothing to Disclose

Alessandro Meschini MD, Abstract Co-Author: Nothing to Disclose

Livio Di Vito MD, Abstract Co-Author: Nothing to Disclose

Giovanni Simonetti MD, Abstract Co-Author: Nothing to Disclose

Massimiliano Marziali MD, Abstract Co-Author: Nothing to Disclose

Emilio Piccione MD, PhD, Abstract Co-Author: Nothing to Disclose

To prospectively investigate diagnostic value and tolerability of MRI with intra-vaginal gel opacification for diagnosis and preoperative assessment of deeply infiltrating endometriosis (DIE).

Sixty-three women with suspicion of DIE were examined with MRI pre and post vaginal gel administration. We evaluated the tolerability of the procedure with a questionnaire from 0 to 3. We assessed with a score from 1 to 4 the visibility of 4 regions: Douglas-pouch, utero-sacral-ligaments (USL), posterior-vaginal-fornix (PVF) and recto-vaginal-septum (RVS). All patients underwent laparoscopic surgery after MRI.

Five patients considered procedure intolerable. Visibility of the USL and PVF was increased with gel (p<0.001). Globally, MRI-sensitivity, specificity, PPV and NPV was 67.8%, 95.3%, 89.4 and 83.5% without gel and 90.8%, 94.6%, 90.8% and 94.6% with gel; sensitivity in the USL evaluation was 47,6% without and 81% with gel (p<0.001); sensitivity in PVF evaluation was 36.4% without and 81.8% with gel (p<0.001); sensitivity in RVS evaluation was 68.7% without and 93.7% with gel (p<0.001); sensitivity in Douglas-pouch was 87% without and 97.4 with gel.

MRI with vaginal gel is recommended for suspicion of DIE because of the added value of better diagnosis of endometriotic lesions, especially in evaluation of PVF and USL.

Intravaginal gel opacification improves the sensibility of pelvic MRI in diagnosis of deeply infiltrating endometriotic lesions

Fiaschetti, V, Crusco, S, Cama, V, Meschini, A, Di Vito, L, Simonetti, G, Marziali, M, Piccione, E, Deeply Infiltrating Endometriosis: Evaluation of Retrocervical Space on MRI after Vaginal Opacification.  Radiological Society of North America 2011 Scientific Assembly and Annual Meeting, November 26 - December 2, 2011 ,Chicago IL. http://archive.rsna.org/2011/11007955.html