Jha Priyanka, Huang Colin, Choi Hailey, VanBuren Wendaline, Poder Liina
Stanford University, Stanford, USA.
University of California, San Francisco, San Francisco, USA.
Abdom Radiol (NY). 2025 Jun 12. doi: 10.1007/s00261-025-05060-1.
To determine whether presence of endometriomas on routine pelvic ultrasound (US) can predict presence of deep infiltrating endometriosis (DE) on magnetic resonance imaging (MRI) and correlate endometrioma size with the presence of DE on MRI.
In this IRB approved, HIPAA compliant study, radiology data base was queried for MRI exams dedicated for endometriosis evaluation in patients with surgically proven endometriosis over a three-year period (2016-2019). Imaging reports were reviewed for the presence of endometriomas and DE on MRI. For the patients with endometriomas, records were reviewed for concurrent routine pelvic US imaging, which were not tailored to DE protocols. US images were reviewed for the presence of endometriomas, their total number, laterality and largest dimension. Descriptive statistics and receiver operating curve (ROC) analysis were performed. Pathology and surgical notes were used as reference standard.
253 patients with surgically confirmed endometriosis underwent MRI for DIE over a 3-year duration. 47 patients had a concurrent US exam. 33/47 patients (70.2%) had endometriomas seen on US (size range 0.9-7.0 cm). 12 had bilateral endometriomas and 13 had multiple (more than 1) endometriomas. 27/33 (82%) of these patients had DE on MRI. 6/33 (18%) patients had additional sites of DE on surgery, which was not reported preoperatively on MRI. When endometriomas more than 3 cm as were evaluated, 19/21 (90%) of patients had DE on MRI. AUC was 0.7106. Using ROC analysis, a threshold of 3.8 cm, provided a sensitivity of 71% and specificity of 78% for detection of DE on MRI.
Presence of endometriomas on routine pelvic US is associated with a high frequency of DE detected on MRI performed for endometriosis. The frequency of DE on MRI was higher in patients with endometrioma size > 3 cm compared to endometriomas of all size range.
确定常规盆腔超声（US）检查时子宫内膜瘤的存在是否能预测磁共振成像（MRI）检查时深部浸润性子宫内膜异位症（DE）的存在，并将子宫内膜瘤大小与MRI检查时DE的存在情况进行关联分析。
在这项经机构审查委员会（IRB）批准且符合健康保险流通与责任法案（HIPAA）的研究中，查询了放射学数据库，获取了在三年期间（2016 - 2019年）因手术证实患有子宫内膜异位症的患者专门用于子宫内膜异位症评估的MRI检查数据。对影像报告进行审查，以确定MRI检查时是否存在子宫内膜瘤和DE。对于患有子宫内膜瘤的患者，审查其同时进行的常规盆腔超声成像记录，这些超声成像并非按照DE检查方案进行。对超声图像进行审查，以确定是否存在子宫内膜瘤、其总数、位置及最大尺寸。进行描述性统计和受试者操作特征曲线（ROC）分析。病理和手术记录用作参考标准。
253例经手术证实患有子宫内膜异位症的患者在3年期间接受了用于评估深部浸润性子宫内膜异位症的MRI检查。47例患者同时进行了超声检查。47例患者中有33例（70.2%）在超声检查中发现有子宫内膜瘤（大小范围为0.9 - 7.0厘米）。12例有双侧子宫内膜瘤，13例有多个（超过1个）子宫内膜瘤。这些患者中有27例（82%）在MRI检查中有DE。6例（18%）患者在手术中发现有额外的DE部位，而MRI术前未报告。当评估大小超过3厘米的子宫内膜瘤时，21例患者中有19例（90%）在MRI检查中有DE。曲线下面积（AUC）为0.7106。使用ROC分析，阈值为3.8厘米时，检测MRI检查中DE的敏感性为71%，特异性为`78%。
常规盆腔超声检查时子宫内膜瘤的存在与为子宫内膜异位症进行的MRI检查中检测到的DE的高频率相关。与所有大小范围的子宫内膜瘤相比，子宫内膜瘤大小>3厘米的患者在MRI检查中DE的频率更高。
