BP- A Beneficência Portuguesa de São Paulo, São Paulo, Brazil.
Disciplina de Ginecologia, Departamento de Obstetrícia E Ginecologia, Hospital das Clínicas HCFMUSP, Faculdade de Medicina, Universidade de São Paulo, Rua São Sebastião, 550, São Paulo, SP, 04708-001, Brazil.
Abdom Radiol (NY). 2021 Jul;46(7):3342-3353. doi: 10.1007/s00261-021-02966-4. Epub 2021 Feb 24.
MRI plays an important role in the diagnosis and surgical planning of pelvic endometriosis (PE), and imaging reports should contain all relevant information (completeness). As structured reports are being increasingly utilized, we aimed to evaluate whether structured MRI reporting increases the quality of reports regarding completeness and, consequently, their perceived value by gynecologists, in comparison to free-text reports. We also aimed to compare the diagnostic performance of both formats.
We retrospectively included 28 consecutive women with histologically proven PE who underwent MRI within one month before surgery. Two abdominal radiologists (Rd1/Rd2, 3y/12y experience), blinded to clinical and surgical data, individually elaborated free-text reports and, four months later, structured reports. Completeness (defined as description of six key anatomical sites deemed essential for surgical planning in a consensus of four-blinded external experts) and diagnostic performance (sensitivity and specificity) by site (histology as reference) were compared between reports using the McNemar test. The satisfaction of gynecologists was compared using the marginal homogeneity test.
Structured reporting increased completeness for both Rd1 (rectosigmoid, retrocervical/uterosacral ligament, vagina, and ureter) and Rd2 (vagina, ureter, and bladder) (p < 0.05), without compromising sensitivity or specificity at any of the evaluated sites. Gynecologists' satisfaction was superior with structured reports in most comparisons.
Structured MRI reports perform better in fully documenting essential features of PE and are similar in terms of diagnostic performance, therefore having higher potential for surgical planning. Gynecologists found them easier to assess and were more satisfied with the information provided by structured reports.
MRI 在盆腔子宫内膜异位症（PE）的诊断和手术规划中发挥着重要作用，影像学报告应包含所有相关信息（完整性）。随着结构化报告的应用日益广泛，我们旨在评估与自由文本报告相比，结构化 MRI 报告是否能提高报告的完整性质量，进而提高妇科医生对其的认可度。我们还旨在比较两种报告格式的诊断性能。
我们回顾性纳入了 28 例经组织学证实的 PE 患者，这些患者在手术前一个月内接受了 MRI 检查。两名腹部放射科医生（Rd1/Rd2，分别具有 3 年和 12 年的经验）在不了解临床和手术数据的情况下，分别独立编写了自由文本报告，四个月后编写了结构化报告。使用 Mcnemar 检验比较报告的完整性（定义为描述四位盲法外部专家一致认为对手术规划至关重要的六个关键解剖部位）和诊断性能（以组织学为参考的敏感性和特异性）。使用边缘同质性检验比较妇科医生的满意度。
结构化报告提高了 Rd1（直肠乙状结肠、宫颈/子宫骶骨韧带、阴道和输尿管）和 Rd2（阴道、输尿管和膀胱）报告的完整性（p<0.05），而不会影响任何评估部位的敏感性或特异性。在大多数比较中，妇科医生对结构化报告的满意度更高。
结构化 MRI 报告在充分记录 PE 的基本特征方面表现更好，在诊断性能方面与自由文本报告相似，因此具有更高的手术规划潜力。妇科医生发现结构化报告更容易评估，并且对其提供的信息更满意。
