Allègre Lucie, Aristizabal Patrick, Nyangoh Timoh Krystel, Thomassin-Naggara Isabelle, Kermarrec Edith, Bendifallah Sofiane, Darai Emile
Department of Obstetrics and Gynecology, Tenon Hospital, Assistance Publique des Hôpitaux de Paris, University Sorbonne, Paris, France.
Department of Obstetrics and Gynecology, Tenon Hospital, Assistance Publique des Hôpitaux de Paris, University Sorbonne, Paris, France.
Eur J Obstet Gynecol Reprod Biol. 2018 Nov;230:172-177. doi: 10.1016/j.ejogrb.2018.09.035. Epub 2018 Sep 25.
To compare 1.5-Tesla (1.5 T) to 3-Tesla (3 T) Magnetic resonance enterography (MRE) in assessing multifocal (multiple lesions affecting the same segment) and multicentric (multiple lesions affecting several digestive segments) bowel endometriosis in patients with suspected-colorectal endometriosis, in routine practice.
We conducted a retrospective, comparative study in Tenon University Hospital, Paris, France. We included patients scheduled for colorectal resection from April 2014 to February 2018. All patients underwent 1.5 T or 3 T MRE before surgery and endometriosis lesions were confirmed by surgery. The diagnostic performance of 1.5 T and 3 T MRE was evaluated by sensitivity, specificity, positive and negative predictive values (PPV and NPV), accuracy, positive and negative likelihood ratios (LR) and area under the curve of receiver operating curves (AUC ROC).
Ninety-eight patients were included. Fifty-two (53%) patients presented unifocal lesions, 31 (32%) multifocal lesions, and 23 (24%) multicentric lesions. In assessment of multifocal lesions, the sensitivity, specificity, positive and negative LRs were 0.57 (12/21), 0.89 (23/26), 4.95 and 0.58 for 1.5 T MRE, and 0.10 (1/10), 0.95 (39/41), 2.05 and 0.95 for 3 T MRE. For the diagnosis of multicentric lesions, 1.5 T MRE showed sensitivity, specificity, positive and negative LRs of 0.46 (5 of 11), 0.92 (33 of 36), 5.45 and 0.60 respectively and 3 T MRE showed sensitivity, specificity, and negative LRs of 0.33 (4/12), 1.00 (39/39), and 0.67, respectively. 1.5 T MRE was more accurate than 3 T MRE for diagnosing multifocal lesions (p = 0.02), but there was no difference for multicentric lesion assessment (p = 0.66).
In routine conditions, 3 T MRE and 1.5 T MRE are of similar low performance for diagnosing multifocal and multicentric bowel endometriosis.
在日常实践中，比较1.5特斯拉（1.5T）与3特斯拉（3T）磁共振肠造影（MRE）在评估疑似结直肠子宫内膜异位症患者的多灶性（同一肠段内有多个病灶）和多中心性（多个肠段有多个病灶）肠道子宫内膜异位症方面的效果。
我们在法国巴黎的特农大学医院进行了一项回顾性比较研究。纳入了2014年4月至2018年2月计划进行结直肠切除术的患者。所有患者在手术前均接受了1.5T或3T MRE检查，且子宫内膜异位症病灶经手术确认。通过敏感性、特异性、阳性和阴性预测值（PPV和NPV）、准确性、阳性和阴性似然比（LR）以及受试者操作特征曲线下面积（AUC ROC）来评估1.5T和3T MRE的诊断性能。
共纳入98例患者。52例（53%）患者为单灶性病变，31例（32%）为多灶性病变，23例（24%）为多中心性病变。在评估多灶性病变时，1.5T MRE的敏感性、特异性、阳性和阴性似然比分别为0.57（12/21）、0.89（23/26）、4.95和0.58，3T MRE分别为0.10（1/10）、0.95（39/41）、2.05和0.95。对于多中心性病变的诊断，1.5T MRE的敏感性、特异性、阳性和阴性似然比分别为0.46（11例中的5例）、0.92（36例中的33例）、5.45和0.60，3T MRE的敏感性、特异性和阴性似然比分别为0.33（4/12）、1.00（39/39）和0.67。1.5T MRE在诊断多灶性病变方面比3T MRE更准确（p = 0.02），但在多中心性病变评估方面无差异（p = 0.66）。
在常规情况下，3T MRE和1.5T MRE在诊断多灶性和多中心性肠道子宫内膜异位症方面表现相似且均较低。
