Marco Maria Maceroni MD, Presenter: Nothing to Disclose

Marco Rengo MD, Abstract Co-Author: Nothing to Disclose

Davide Bellini MD, Abstract Co-Author: Nothing to Disclose

Damiano Caruso MD, Abstract Co-Author: Nothing to Disclose

Fabrizio Vecchietti MD, Abstract Co-Author: Nothing to Disclose

Andrea Laghi MD, Abstract Co-Author: Research Consultant, Bracco Group Research Consultant, Vital Images, Inc Research Consultant, General Electric Company Research Consultant, iCAD, Inc

To compare the accuracy of MRI of the pelvis for the evaluation of deep pelvic endometriosis at 3 and 1.5 Tesla.

Thirty patients with deep pelvic pain (mean age: 33; years range: 20–46 years), suspected of having deep pelvic endometriosis underwent first MRI examination at 1,5T first and,within one week, at 3T. Diagnosis of deep pelvic endometriosis was defined as implants or tissue that appeared with signal intensity close to pelvic muscle with or without small hyperintense foci in T1 or T2 pulse sequence in the following sites (giving each a score according to their frequenzy): torus uterinus and utero-sacral ligaments (1), recto-vaginal septum (2), intestinal (3) and urinary tract (4). Two experienced radiologists evaluated, independently, MRI datasets assessing number and location of implants as well as image quality and diagnostic confidence. Quantitative and qualitative scores were compared. Inter-reader agreement was also evaluated.

Deep pelvic endometriosis was diagnosed alone (n.18) or combined with endometriomas (n.7) or adenomiosis (n.5). More implants were detected on 3T (n.39) compared to 1.5T (n.33): 19 (17) implants localized at the level of torus uterinus and LUS, 9 (8) into recto-vaginal septum, 8 (6) in intestinal tract and 3 (2) in urinary tract. Inter-reader agreement resulted non significantly higher at 3T (0.82 and 0.78; p=0.06). Diagnostic confidence was significantly higher at 3T (p> 0.02).

Both MRI at 1.5T and 3T have shown an high accuracy in deep pelvic endometriosis (DPE) detection; however 3T MRI detected more DEP implants with a significant improvement of diagnostic confidence.

The clinical assessment of patients with suspected DEP is difficult with physical examination alone. Three tesla MRI, with its high accuracy in implants detection, makes pre-operatory staging easier.

Maceroni, M, Rengo, M, Bellini, D, Caruso, D, Vecchietti, F, Laghi, A, Deep Pelvic Endometriosis at 3 Tesla: Comparison with 1.5 Tesla.  Radiological Society of North America 2011 Scientific Assembly and Annual Meeting, November 26 - December 2, 2011 ,Chicago IL. http://archive.rsna.org/2011/11012387.html