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Exploratory study of the interest of MR susceptibility-weighted imaging for the pre-operative assessment of pelvic endometriosis extent

2019; Elsevier BV; Volume: 118; Linguagem: Inglês

10.1016/j.ejrad.2019.06.018

1872-7727

Louis Pin, Anne-Coline Monseau-Thiburce, Caroline Ziade-Coularis, Alice Benjamin, Fanny Menut, Jean-Luc Brun, Benjamin Merlot, Jean‐François Chateil,

Endometrial and Cervical Cancer Treatments

To evaluate the performance of magnetic resonance imaging (MRI) with susceptibility-weighted imaging (SWI) in the assessment of endometriosis.This prospective study was performed during the diagnostic step or the pre-operative assessment of endometriosis, between June 2017 and April 2018. The MRI was conducted with a 3T MRI device; protocol included T2W, T1W, with and without fat-saturation sequences completed with a SWI sequence: T2-star weighted angiography (SWAN). The diagnostic performance values of MRI and inter-observer agreement were first evaluated with a conventional MR protocol and then with the complementary SWAN sequence by 2 readers. MRI results were correlated with surgical findings in patients who underwent laparoscopy.74 patients were included in the study, and among them 10 patients were treated by laparoscopy. 81% of the endometriosis lesions had signal losses on the SWAN sequence related to hemorrhagic character whereas only 52% of the lesions had T1-weighted hyperintense implants. Diagnostic performance of the MRI examination was improved by the use of the SWAN sequence compared to the conventional MR protocol (Se = 94% and Spe = 73% in complete protocol and Se = 88% and Spe = 69% in conventional protocol), especially for the involvement of torus uterinus, utero-sacral ligament and retro-cervical site. An excellent interobserver agreement (қ-value = 0,94) was noted between the two readers.SWI can improve the diagnostic accuracy of MRI by allowing the detection of hemorrhagic character of endometriosis lesions.