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Learning curve in the detection of ovarian and deep endometriosis by using Magnetic Resonance: comparison with surgical results.

Abstract：

PURPOSE:Determining if Magnetic Resonance Imaging (MRI) accuracy in diagnosing endometriosis is related to radiologist's expertise. METHODS AND MATERIALS:Written informed consent was obtained from all patients. This study is compliant to STARD method. Thirty patients (mean age 34; range 21-45 years) who had undergone MRI study for suspected endometriosis underwent surgery were retrospectively evaluated. MRI at 1.5T was performed with SE and TSE sequences, T1 and T2-weighted with and without fat suppression. Four localizations were analyzed: ovary, uterosacral ligaments (USL), vaginal fornix and Rectum\Sigma\Douglas (R.S.D.). One radiologist evaluated each dataset; sensitivity, specificity, PPV and NPV, accuracy, LR+ and LR- were calculated according to the surgical results (first analysis). Dataset were then re-analyzed 12 months (second analysis) and 24 months (third analysis) later. McNemar test was applied to determine differences between the three analysis. RESULTS:Sensitivity, specificity and accuracy for the ovary at the first analysis were 88.9%, 87% and 88%, at the second 92.6%, 87% and 90% whereas at the third 92.6%, 91.3% and 92%. Sensitivity, specificity and accuracy for the USLs at the first analysis were 62.5%, 76.9% and 70%, at the second 72%, 80.8% and 76% whereas at the third 80%, 84.6% and 82%. Sensitivity, specificity and accuracy for the vaginal fornix at the first analysis were 63.2%, 64.5% and 64%, at the second 73.7%, 77.4% and 76% whereas at the third 73.7%, 83.9% and 80%. Sensitivity, specificity and accuracy for the R.S.D. at the first analysis were 39.1%, 81.5% and 62%, at the second 62.5%, 85.2% and 76% whereas at the third 73.9%, 88.9% and 82%. McNemar test indicated a significant statistical difference in sensitivity in detecting nodules of endometriosis in R.S.D. between first and third analysis (p=0.0215). The mean review time decreased (p=0.0001). CONCLUSIONS:Accuracy of MRI in diagnosing endometriosis increased with radiologist's expertise and the improvement was statistically significant in determining RSD involvement.

journal_name

Eur J Radiol

journal_title

European journal of radiology

authors

Saba L,Guerriero S,Sulis R,Pilloni M,Ajossa S,Melis G,Mallarini G

doi

10.1016/j.ejrad.2010.01.019

subject

Has Abstract

pub_date

2011-08-01 00:00:00

pages

237-44

issue

eissn

0720-048X

issn

1872-7727

pii

S0720-048X(10)00050-1

journal_volume

pub_type

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Learning curve in the detection of ovarian and deep endometriosis by using Magnetic Resonance: comparison with surgical results.