Department of Surgery, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands.
Department of Surgery, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands; Department of Reproductive Medicine, Endometriosis Centre Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands.
Clin Radiol. 2023 Sep;78(9):661-665. doi: 10.1016/j.crad.2023.04.010. Epub 2023 May 9.
To assess the correlation between magnetic resonance imaging (MRI) and histopathology for predicting muscular infiltration of endometriosis in the bowel wall in patients undergoing colorectal resection.
All consecutive patients who underwent colorectal surgery for deep endometriosis (DE) with a preoperative MRI in a single tertiary care referral hospital between 2001 and 2019 were included in a prospective cohort. MRI images were revised by a single blinded radiologist. The MRI results regarding the infiltration depth (serosal, muscular, submucosal, or mucosal) and lesion expansion of DE were compared to histopathology.
A total of 84 patients were eligible for evaluation. A sensitivity of 89% and positive predictive value of 97% was shown for predicting muscular involvement of the bowel wall.
This study showed that MRI is valuable in predicting the involvement of the muscular layer of the colorectal wall. Therefore, in patients with symptomatic pelvic bowel endometriosis MRI is a useful tool in guiding the extent of colorectal surgery.
评估磁共振成像（MRI）与组织病理学在预测接受结直肠切除术的患者肠壁内子宫内膜异位症肌肉浸润中的相关性。
本研究纳入了 2001 年至 2019 年间在一家三级转诊医院接受 MRI 术前检查并因深部子宫内膜异位症（DE）而行结直肠手术的所有连续患者，进行了前瞻性队列研究。由一名单独的盲法放射科医生对 MRI 图像进行了修订。将 MRI 结果（关于 DE 的浸润深度（浆膜、肌肉、黏膜下或黏膜）和病变扩展）与组织病理学进行了比较。
共有 84 名患者符合评估条件。MRI 预测肠壁肌肉受累的敏感性为 89%，阳性预测值为 97%。
本研究表明 MRI 可用于预测结直肠壁的肌肉层受累。因此，对于有症状的盆腔肠内子宫内膜异位症的患者，MRI 是指导结直肠手术范围的有用工具。
