Department of Radiology, Mayo Clinic, 200 First Street SW, Rochester, MN, 55905, USA.
Department of Obstetrics and Gynecology, Mayo Clinic, 200 First Street SW, Rochester, MN, 55905, USA.
Abdom Radiol (NY). 2020 Jun;45(6):1670-1679. doi: 10.1007/s00261-019-02124-x.
To estimate the benefit of pelvic magnetic resonance (MR) imaging after routine pelvic ultrasound (US) in patients with pathologically or surgically proven endometriosis.
Patients with surgically or pathologically proven endometriosis who had routine pelvic US followed by pelvic MR within 6 months prior to surgery were included. Patients were excluded if they had previously confirmed endometriosis, pregnancy, or surgery > 6 months after MR. The detection rate of endometriosis by pelvic US and MR was compared to the surgical/pathological reference standard.
83 female patients (mean age 40 ± 9) met inclusion criteria and had surgical/pathological confirmation of endometriosis. The mean time interval between pelvic US and MR was 33 ± 43 days, with 64 ± 69 days between MR examination and surgery. US detected endometriosis in 22% (18/83) of patients compared to 61% (51/83) for MR (p < 0.0001). 51% (33/65) of patients with a negative pelvic US exam had a positive MR. MR identified additional sites or sequela in the majority of patients with a positive US (14/18; 78%), including extraovarian locations [e.g., fallopian tubes 7/18 (39%), uterus 7/18 (39%), uterine ligaments 6/18 (33%), posterior cul de sac 5/18 (28%), pelvic side walls 5/18 (28%), abdominal wall 1/18 (6%)] and sequela [ovarian tethering 5/18 (28%), 6/18 (33%) bowel adhesive disease, posterior cul de sac obliteration 2/18 (11%), hydrosalpinx 2/18 (11%), and hydronephrosis 1/18 (6%)]. 3 T MR detected endometriosis in 33/46 (72%) patients compared to 18/37 (49%) for 1.5 T MR (p = 0.03).
Pelvic MR imaging had a higher detection rate of surgically/pathologically proven endometriosis and provides more information about disease location and sequela compared to routine pelvic US.
评估在经病理或手术证实患有子宫内膜异位症的患者中，常规盆腔超声（US）后行盆腔磁共振（MR）检查的获益。
纳入了在手术前 6 个月内行常规盆腔 US 检查后紧接着行盆腔 MR 检查且经手术或病理证实患有子宫内膜异位症的患者。如果患者此前已确诊为子宫内膜异位症、妊娠或 MR 检查后 6 个月以上行手术，则将其排除。将盆腔 US 和 MR 检查对子宫内膜异位症的检出率与手术/病理参考标准进行比较。
83 名女性患者（平均年龄 40±9 岁）符合纳入标准，并经手术/病理证实患有子宫内膜异位症。盆腔 US 和 MR 检查之间的平均时间间隔为 33±43 天，MR 检查和手术之间的平均时间间隔为 64±69 天。US 检查检出子宫内膜异位症的比例为 22%（18/83），而 MR 检查的检出率为 61%（51/83）（p＜0.0001）。65%（33/51）的 MR 检查阴性患者的盆腔 US 检查结果为阳性。在大多数 US 检查阳性的患者中（14/18；78%），MR 检查均识别到了额外的部位或后遗症，包括卵巢外部位[例如，输卵管 18 例中的 7 例（39%）、子宫 18 例中的 7 例（39%）、子宫韧带 18 例中的 6 例（33%）、后穹窿 18 例中的 5 例（28%）、骨盆侧壁 18 例中的 5 例（28%）、腹壁 18 例中的 1 例（6%）]和后遗症[卵巢固定 18 例中的 5 例（28%）、肠粘连病 18 例中的 6 例（33%）、后穹窿闭塞 18 例中的 2 例（11%）、输卵管积水 18 例中的 2 例（11%）和肾盂积水 18 例中的 1 例（6%）]。3T MR 检查对 46 例患者中的 33 例（72%）检出了子宫内膜异位症，而 1.5T MR 检查对 37 例患者中的 18 例（49%）检出了子宫内膜异位症（p=0.03）。
与常规盆腔 US 相比，盆腔 MR 检查对经手术/病理证实患有子宫内膜异位症的患者的检出率更高，并能提供更多关于疾病部位和后遗症的信息。
