[Diagnostic performance of MR imaging, coloscan and MRI/CT enterography for the diagnosis of pelvic endometriosis: CNGOF-HAS Endometriosis Guidelines].

Gynecol Obstet Fertil Senol

Service de chirurgie gynécologique oncologique, obstétrique, CHU Lyon Sud, 165, chemin du Grand-Revoyet, 69495 Pierre-Bénite, France; Université Claude-Bernard Lyon 1, 69000 Lyon, France; Service de gynécologie-obstétrique et médecine de la reproduction, CHU de Tenon, AP-HP, 4, rue de la Chine, 75020 Paris, France; Inserm, UMR S 938, faculté de médecine Pierre-et Marie-Curie, Site Saint-Antoine, 27, rue Chaligny, 75571 Paris cedex 12, France.

Published: March 2018

Diagnostic performance of MR imaging for the diagnosis of pelvic endometriosis are good. Even if some differences of performances exists according the location considered, the risk of misdiagnosis is lower than 10% for trained teams (NP2). The performance of pelvic MR imaging and surgery are quite similar to diagnose endometrioma (sensitivity and specificity>90%). A negative pelvic MR imaging allows to exclude deep pelvic endometriosis with a performance similar to surgery but a positive MR imaging is less accurate than surgery because of a high number of false positives (23%). Pelvic MR imaging is more sensitive and less specific than ultrasonography for the diagnosis of uterosacral ligament, vagina or recto vaginal septum (NP2). Pelvic ultrasonography is more sensitive than pelvic MR imaging for the diagnosis of colorectal location (NP3). Pelvic MR imaging is a reproducible technique for the diagnosis of pelvic endometriosis (NP3). Regarding, quality criteria of pelvic MR imaging, no data are enough to recommend a specific MR unit, digestive preparation, or a specific moment during the menstrual cycle to realize the examination. Vaginal and/or rectal opacification are options. Most of studies are based a protocol including 3D T2W and 3DT1W sequences. Gadolinium injection is useful to characterize a complex adnexal mass. In clinical routine, slices crossing the kidneys are useful to evaluate the presence of pyelo calic distension. ColoCT is an accurate technique to diagnose pelvic digestive endometriosis (rectosigmoide and iléocaecal) (NP3).

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http://dx.doi.org/10.1016/j.gofs.2018.02.023DOI Listing

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