Accuracy of magnetic resonance imaging in diagnosis of adenomyosis and endometriosis.

ABSTRACT

Objective: To evaluate the utility of Magnetic Resonance Imaging (MRI) in the diagnosis of adenomyosis and endometriosis. Methods: Medical records of 38 women who underwent laparoscopy or laparotomy less than 4 weeks after preoperative MRI were reviewed. MRI results were evaluated for the diagnosis of adenomyosis of the uterus, ovarian endometrioma, peritoneal endometriotic implants, endometriosis of bladder, bowel and rectovaginal septum. Surgical and histological findings were used as a gold standard. Results: Adenomyosis was found in 7 (18.4%) of 38 patients. Endometriosis was diagnosed in 30 (78.9%) of 38 patients. The sensitivity, specificity, and accuracy of MRI for diagnosing adenomyosis were 85.7, 100, and 90.9% respectively. The sensitivity, specificity, and accuracy of MRI for the diagnosis of endometriosis in specific sites were as follows; endometrioma, 81.5, 96.6, and 93.4% respectively; peritoneal implants, 25, 100, and 60.5% respectively; bladder, 66.6, 100, and 97.3% respectively; rectovaginal septum, 90, 100, and 97.3% respectively; bowel, 71.4, 100, and 94.7%, respectively. Conclusion: MRI provides high accuracy in the diagnosis of adenomyosis and endometriosis with an exception for the diagnosis of peritoneal endometriotic implants.