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Alonzo L, Cannella R, Gullo G, Piombo G, Cicero G, Lopez A, Billone V, Andrisani A, Cucinella G, Lo Casto A, Lo Re G. Magnetic Resonance Imaging of Endometriosis: The Role of Advanced Techniques. J Clin Med 2024; 13:5783. [PMID: 39407843 PMCID: PMC11476566 DOI: 10.3390/jcm13195783] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2024] [Revised: 09/04/2024] [Accepted: 09/23/2024] [Indexed: 10/20/2024] Open
Abstract
Endometriosis is a chronic inflammatory disease that affects about 10% of women, and it is characterized by the presence of endometrial tissue outside the uterine cavity. Associated symptoms are dyspareunia, chronic pelvic pain, and infertility. The diagnosis of endometriosis can be challenging due to various clinical and imaging presentations. Laparoscopy is the gold standard for the diagnosis, but it is an invasive procedure. The literature has increasingly promoted a switch to less invasive imaging techniques, such as ultrasound and magnetic resonance imaging (MRI). The latter, also in relation to the latest technological advances, allows a comprehensive and accurate assessment of the pelvis and it can also identify sites of endometriosis that escape laparoscopic evaluation. Furthermore, MRI has been found to be more accurate than other imaging techniques in relation to its improved sensitivity and specificity in identifying disease sites, also due to the role of new emerging sequences. This article aims to review the current role of advanced MRI applications in the assessment of endometriosis.
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Affiliation(s)
- Laura Alonzo
- Department of Biomedicine, Neuroscience and Advanced Diagnostic (BI.N.D.), University of Palermo, 90127 Palermo, Italy; (L.A.); (G.P.); (A.L.C.); (G.L.R.)
| | - Roberto Cannella
- Department of Biomedicine, Neuroscience and Advanced Diagnostic (BI.N.D.), University of Palermo, 90127 Palermo, Italy; (L.A.); (G.P.); (A.L.C.); (G.L.R.)
| | - Giuseppe Gullo
- Unit of Obstetrics and Gynecology, AOOR Villa Sofia Cervello, University of Palermo, 90100 Palermo, Italy; (G.G.); (A.L.); (V.B.); (G.C.)
| | - Giulia Piombo
- Department of Biomedicine, Neuroscience and Advanced Diagnostic (BI.N.D.), University of Palermo, 90127 Palermo, Italy; (L.A.); (G.P.); (A.L.C.); (G.L.R.)
| | - Giuseppe Cicero
- Department of Precision Medicine in Medical, Surgical and Critical Care Area, University of Palermo, 90127 Palermo, Italy;
| | - Alessandra Lopez
- Unit of Obstetrics and Gynecology, AOOR Villa Sofia Cervello, University of Palermo, 90100 Palermo, Italy; (G.G.); (A.L.); (V.B.); (G.C.)
| | - Valentina Billone
- Unit of Obstetrics and Gynecology, AOOR Villa Sofia Cervello, University of Palermo, 90100 Palermo, Italy; (G.G.); (A.L.); (V.B.); (G.C.)
| | - Alessandra Andrisani
- Unit of Gynecology and Obstetrics, Department of Women and Children’s Health, University of Padua, 35128 Padua, Italy;
| | - Gaspare Cucinella
- Unit of Obstetrics and Gynecology, AOOR Villa Sofia Cervello, University of Palermo, 90100 Palermo, Italy; (G.G.); (A.L.); (V.B.); (G.C.)
| | - Antonio Lo Casto
- Department of Biomedicine, Neuroscience and Advanced Diagnostic (BI.N.D.), University of Palermo, 90127 Palermo, Italy; (L.A.); (G.P.); (A.L.C.); (G.L.R.)
| | - Giuseppe Lo Re
- Department of Biomedicine, Neuroscience and Advanced Diagnostic (BI.N.D.), University of Palermo, 90127 Palermo, Italy; (L.A.); (G.P.); (A.L.C.); (G.L.R.)
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Takeuchi M, Matsuzaki K, Harada M. Endometriosis, a common but enigmatic disease with many faces: current concept of pathophysiology, and diagnostic strategy. Jpn J Radiol 2024; 42:801-819. [PMID: 38658503 PMCID: PMC11286651 DOI: 10.1007/s11604-024-01569-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2024] [Accepted: 04/06/2024] [Indexed: 04/26/2024]
Abstract
Endometriosis is a benign, common, but controversial disease due to its enigmatic etiopathogenesis and biological behavior. Recent studies suggest multiple genetic, and environmental factors may affect its onset and development. Genomic analysis revealed the presence of cancer-associated gene mutations, which may reflect the neoplastic aspect of endometriosis. The management has changed dramatically with the development of fertility-preserving, minimally invasive therapies. Diagnostic strategies based on these recent basic and clinical findings are reviewed. With a focus on the presentation of clinical cases, we discuss the imaging manifestations of endometriomas, deep endometriosis, less common site and rare site endometriosis, various complications, endometriosis-associated tumor-like lesions, and malignant transformation, with pathophysiologic conditions.
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Affiliation(s)
- Mayumi Takeuchi
- Department of Radiology, Tokushima University, 3-18-15, Kuramoto-Cho, Tokushima, 7708503, Japan.
| | - Kenji Matsuzaki
- Department of Radiological Technology, Tokushima Bunri University, Sanuki City, ShidoKagawa, 1314-17692193, Japan
| | - Masafumi Harada
- Department of Radiology, Tokushima University, 3-18-15, Kuramoto-Cho, Tokushima, 7708503, Japan
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Capozzi VA, Scarpelli E, dell’Omo S, Rolla M, Pezzani A, Morganelli G, Gaiano M, Ghi T, Berretta R. Atypical Endometriosis: A Comprehensive Systematic Review of Pathological Patterns and Diagnostic Challenges. Biomedicines 2024; 12:1209. [PMID: 38927416 PMCID: PMC11201022 DOI: 10.3390/biomedicines12061209] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2024] [Revised: 05/20/2024] [Accepted: 05/27/2024] [Indexed: 06/28/2024] Open
Abstract
Endometriosis is a benign condition affecting women of reproductive age. A potential association with ovarian cancer has been documented. Atypical endometriosis (AE) is characterized by deviations from the typical microscopic appearance of endometriosis, including cytologic and architectural atypia. AE has been recognized as a potential precursor to endometriosis-associated ovarian cancers (EAOC), particularly endometrioid and clear cell subtypes. AE presents challenges in diagnosis due to its diverse clinical and pathological features, often requiring careful histological evaluation for accurate identification. Architectural AE, defined by localized proliferation of crowded glands with atypical epithelium resembling endometrial neoplasia, and cytologic AE, characterized by nuclear atypia within the epithelial lining of endometriotic cysts, are key subtypes. Immunohistochemical and molecular studies have revealed aberrant expression of markers such as Ki67, COX-2, BAF250a, p53, estrogen receptor, progesterone receptor, and IMP-3. Long-term follow-up studies suggest relatively low recurrence and malignant transformation rates among patients with AE, but uncertainties persist regarding its exact malignancy potential and optimal management strategies. Integration of artificial intelligence and shared molecular aberrations between AE and EAOC may enhance diagnostic accuracy. Continuous interdisciplinary collaboration and ongoing research efforts are crucial for a deeper understanding of the relationship between endometriosis and carcinogenesis, ultimately improving patient care and surveillance.
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Affiliation(s)
| | | | | | - Martino Rolla
- Department of Obstetrics and Gynecology, University Hospital of Parma, 43125 Parma, Italy
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Shao H, Wang N, Liu G. Factors Affecting the Diagnostic Discordance Between Frozen and Permanent Sections in Mucinous Ovarian Tumors. Int J Womens Health 2024; 16:853-863. [PMID: 38774151 PMCID: PMC11108062 DOI: 10.2147/ijwh.s458138] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2024] [Accepted: 05/11/2024] [Indexed: 05/24/2024] Open
Abstract
Purpose To investigate the accuracy of intraoperative frozen section (FS) diagnosis for predicting the permanent section (PS) diagnosis of mucinous ovarian tumors and evaluate the factors affecting the diagnostic discordance. Patients and Methods This retrospective cohort study was performed in Tianjin Medical University General Hospital. All women who underwent ovarian surgery with FS between January 2011 and December 2022 were identified, and those with a diagnosis of mucinous ovarian tumor (MOT) by FS or PS were reviewed. Clinical and pathologic data were extracted. Results A total of 180 women were included, of which 141 (78.33%) had diagnostic concordance between FS and PS, yielding a sensitivity of 83.43% and a positive predictive value (PPV) of 92.76%. Under- and over-diagnosis occurred in 28 cases (15.56%) and 11 cases (6.11%). Tumor size > 13cm (OR 3.79, 95% CI 1.12-12.73) was an independent risk factor for under-diagnosis, and tumor size ≤ 13cm (OR 16.78, 95% CI 0.01-0.49), laparoscopic surgery (OR 0.14, 95% CI 0.02-0.92), the combination of other tumor components (including serous, Brenner tumor, and chocolate cyst; OR 7.00, 95% CI 1.19-41.12) were independently associated with over-diagnosis. The Kaplan-Meier survival curves and the Log rank test showed no significant difference between misdiagnosed and accurately diagnosed patients (all P > 0.05). Conclusion Intraoperative frozen pathology of MOT is problematic for under- and over-diagnosis. The incorrect diagnosis of FS was related to determining the extent of surgery but had no impact on the patients' long-term recurrence and survival outcomes. In future clinical practice, surgeons need to obtain material accurately and enhance communication with pathologists during the operation to improve the accuracy of FS diagnosis.
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Affiliation(s)
- Hua Shao
- Clinical Psychology Department, Tianjin Medical University General Hospital, Tianjin, People’s Republic of China
| | - Na Wang
- Gynecology and Obstetrics Department, Tianjin Haihe Hospital, Tianjin, People’s Republic of China
| | - Guoyan Liu
- Gynecology and Obstetrics Department, Tianjin Medical University General Hospital, Tianjin, People’s Republic of China
- Gynaecological Oncology Department, Tianjin Medical University Cancer Institute and Hospital, Tianjin, People’s Republic of China
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Hayashi T, Konishi I. Molecular Histopathology for Establishing Diagnostic Method and Clinical Therapy for Ovarian Carcinoma. J Clin Med Res 2023; 15:68-75. [PMID: 36895622 PMCID: PMC9990723 DOI: 10.14740/jocmr4853] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2022] [Accepted: 02/11/2023] [Indexed: 03/04/2023] Open
Abstract
Ovarian carcinoma (OC) is considered the deadliest gynecological malignancy. It is typically diagnosed in the advanced stages of the disease, with metastatic sites widely disseminated within the abdominal cavity. OC treatment is challenging due to the high rate of disease recurrence, which is further complicated by acquired chemoresistance caused by the reversion of the pathological variant. Therefore, more effective treatments are still being sought. Histologically, OC is classified into serous, mucinous, endometrioid, clear cell, and transitional cell carcinomas and malignant Brenner tumor. Recent clinicopathological and molecular biological studies demonstrated that these subtypes differ in histogenesis and anti-tumor agent sensitivity. In Japan, the incidence rates of the histological types of OC, namely, serous carcinoma, mucinous carcinoma, endometrioid carcinoma, and clear cell adenocarcinoma, are 39%, 12%, 16%, and 23%, respectively. Serous carcinoma is classified as high or low grade, with the former accounting for the overwhelming majority. In this study, the molecular pathological classification of OC has been described based on the characteristics of the two types of OC, types 1 and 2. Compared with Europe and the United States, Japan has a higher prevalence of type 1 OC and a lower prevalence of type 2 OC. The prevalence of each type of OC varies by race. It has been elucidated that the prevalence rate of each type of ovarian cancer in Asian countries is similar to that in Japan. Thus, OC is a heterogeneous disease. Furthermore, OC has been attributed to molecular biological mechanisms that vary among tissue subtypes. Therefore, it is necessary to conduct treatment based on accurate diagnoses of each tissue type and establish an optimal treatment strategy, and now is the transition period.
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Affiliation(s)
- Takuma Hayashi
- National Hospital Organization Kyoto Medical Center, Fukakusa Mukaihata-cho, Kyoto 612-8555, Japan
| | - Ikuo Konishi
- National Hospital Organization Kyoto Medical Center, Fukakusa Mukaihata-cho, Kyoto 612-8555, Japan
- Kyoto University, Graduate School of Medicine, Sakyo-ku, Kyoto 606-8507, Japan
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Younis JS. Endometriosis-Associated Ovarian Cancer: What Are the Implications for Women with Intact Endometrioma Planning for a Future Pregnancy? A Reproductive Clinical Outlook. Biomolecules 2022; 12:1721. [PMID: 36421735 PMCID: PMC9688199 DOI: 10.3390/biom12111721] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2022] [Revised: 11/14/2022] [Accepted: 11/18/2022] [Indexed: 08/16/2023] Open
Abstract
Endometriosis is a chronic, universal, and prevalent disease estimated to affect up to 1:10 women of reproductive age. Endometriosis-associated ovarian cancer (EAOC) developing at reproductive age is challenging and of concern for women and practitioners alike. This outlook review focuses on the occurrence of EAOC, especially in infertile women or those planning for a future pregnancy, from the perspective of a reproductive endocrinologist, based on recent evidence. Contemporary pathogenesis, genetic profiles, evidence of causality, clinical diagnosis, prognosis, and up-to-date management are discussed. EAOC seems to be merely associated with endometrioma and includes clear-cell and endometrioid ovarian carcinoma. Although endometrioma is frequently found in women of reproductive age (up to 1:18 of women), EAOC appears to be a rare occurrence. These women are of more advanced reproductive age, nulliparous, and hyperestrogenic, with a large-sized unilateral endometrioma (>9 cm) containing solid components and papillary projections. Each case suspected to have EAOC has specific characteristics, and a multidisciplinary discussion and appropriate patient counseling should be conducted to reach an optimal therapeutic plan. Since most of these cases are diagnosed at an early stage with a favorable prognosis, fertility-sparing surgery may be feasible. The pros and cons of fertility preservation techniques should be discussed.
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Affiliation(s)
- Johnny S. Younis
- Reproductive Medicine, Department of Obstetrics and Gynecology, Baruch-Padeh Medical Center, Poriya 15208, Israel; ; Tel.: +972-505286981; Fax: +972-46737478
- Azrieli Faculty of Medicine in Galilee, Bar-Ilan University, Safed 1311502, Israel
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Kido A, Himoto Y, Moribata Y, Kurata Y, Nakamoto Y. MRI in the Diagnosis of Endometriosis and Related Diseases. Korean J Radiol 2022; 23:426-445. [PMID: 35289148 PMCID: PMC8961012 DOI: 10.3348/kjr.2021.0405] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2021] [Revised: 10/15/2021] [Accepted: 11/11/2021] [Indexed: 11/15/2022] Open
Abstract
Endometriosis, a common chronic inflammatory disease in female of reproductive age, is closely related to patient symptoms and fertility. Because of its high contrast resolution and objectivity, MRI can contribute to the early and accurate diagnosis of ovarian endometriotic cysts and deeply infiltrating endometriosis without the need for any invasive procedure or radiation exposure. The ovaries, which are the most frequent site of endometriosis, can be afflicted by multiple related conditions and diseases. For the diagnosis of deeply infiltrating endometriosis and secondary adhesions among pelvic organs, fibrosis around the ectopic endometrial gland is usually found as a T2 hypointense lesion. This review summarizes the MRI findings obtained for ovarian endometriotic cysts and their physiologically and pathologically related conditions. This article also includes the key imaging findings of deeply infiltrating endometriosis.
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Affiliation(s)
- Aki Kido
- Department of Diagnostic Imaging and Nuclear Medicine, Kyoto University Hospital, Kyoto, Japan
| | - Yuki Himoto
- Department of Diagnostic Imaging and Nuclear Medicine, Kyoto University Hospital, Kyoto, Japan
| | - Yusaku Moribata
- Department of Diagnostic Imaging and Nuclear Medicine, Kyoto University Hospital, Kyoto, Japan
| | - Yasuhisa Kurata
- Department of Diagnostic Imaging and Nuclear Medicine, Kyoto University Hospital, Kyoto, Japan
| | - Yuji Nakamoto
- Department of Diagnostic Imaging and Nuclear Medicine, Kyoto University Hospital, Kyoto, Japan
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Zhang X, Li M, Tang Z, Li X, Song T. Differentiation between endometriosis-associated ovarian cancers and non- endometriosis-associated ovarian cancers based on magnetic resonance imaging. Br J Radiol 2021; 94:20201441. [PMID: 33882252 DOI: 10.1259/bjr.20201441] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
OBJECTIVES Endometriosis-associated ovarian cancer (EAOC) patients show different clinical characteristics compared with non-EAOC patients. However, a few studies are focused on the imaging characteristics of EAOC until now. We assessed MRI characteristics in differentiating EAOC and non-EAOC. METHODS We retrospectively analyzed clinical and MRI characteristics from 54 patients with 67 lesions diagnosed with primary epithelial ovarian carcinoma at the Third Affiliated Hospital of Guangzhou Medical University between January 2012 and October 2020. We studied MRI findings such as maximum diameter, morphology, configuration, locularity, features of mural nodules, lymphadenopathy, peritoneal implants, the presence of hyperintensity on T1WI, and hypointensity on T2WI. We also studied the clinical characteristics. Significant MRI variables in univariate analysis were selected for subsequent multivariate regression analysis. This study evaluated the diagnostic performance of the significant MRI variables in univariate analysis. RESULTS We found that the patients with EAOC, compared with those with non-EAOC, were younger, more unilateral, and had earlier FIGO stage. Univariate analysis revealed that morphology, locularity, growth pattern of mural nodules, and hypointensity on T2WI were factors that significantly differed between EAOC and non-EAOC. In the multivariate logistic regression analysis, locularity and hypointensity on T2WI were independent predictors to distinguish EAOC from non-EAOC. CONCLUSIONS EAOC typically presented as a unilocular mass with hypointensity on T2WI in cystic components. MRI could help distinguish EAOC from non-EAOC. ADVANCES IN KNOWLEDGE MRI is a promising tool for preoperative diagnosis of EAOC.
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Affiliation(s)
- Ximing Zhang
- Department of Radiology, The Third Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
| | - Min Li
- Department of Radiology, The Third Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
| | - Zhuopeng Tang
- Department of Radiology, The Third Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
| | - Xinyi Li
- Department of Radiology, The Third Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
| | - Ting Song
- Department of Radiology, The Third Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
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Zhang Y, Li Y, Wu M, Zhang F, Shao G, Wang Q. Analysis and Evaluation of Ultrasound Imaging Features and Pathological Results of Ovarian Cancer. JOURNAL OF MEDICAL IMAGING AND HEALTH INFORMATICS 2021. [DOI: 10.1166/jmihi.2021.3349] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
To compare and analyze the relationship between the characteristics of ultrasound images of ovarian cancer and the results of postoperative pathological examination. A retrospective analysis of 206 patients with suspected ovarian cancer confirmed by surgical pathology was taken as the
research object. The location, size, morphology, partition and wall nodules, cystic solidity, and signal characteristics of the tumor were observed and compared with the results of postoperative pathological examination evaluation and analysis to improve the early clinical diagnosis of ovarian
cancer patients. By regression analysis of the histological examination of patients with ovarian tumors of different ages and the proportion of cox postoperative recurrence risk regression models, 154 of 206 ovarian tumor patients were ovarian cancer. There were significant differences in
pathological types, lesion locations, maximum diameter lengths, and internal echo in patients with ovarian malignant tumors at different ages (p < 0.05). Ultrasound of ovarian cancer shows that the tumor has large tumor body, strong echo, cyst wall has protrusions, and peripheral
and internal blood flow that is mainly high-speed and low-resistance. The sensitivity, specificity, and accuracy of ultrasound for ovarian cancer diagnosis are 84.38%, 66.67%, 81.01%. The accuracy, specificity, and sensitivity of early diagnosis of clinical ovarian cancer patients by ultrasound
imaging features provide sufficient imaging evidence to further promote the clinical judgment of benign and malignant tumors, which is beneficial to doctors’ clinical treatment of ovarian cancer patients. The early diagnosis and the higher clinical value were shown.
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Affiliation(s)
- Yuqing Zhang
- Department of Radiology, Ultrasound Division, The Second Hospital of Shandong University, Jinan 250033, Shandong, China
| | - Yan Li
- Department of Nuclear Medicine, The Second Hospital of Shandong University, Jinan 250033, Shandong, China
| | - Mei Wu
- Department of Radiology, Ultrasound Division, The Second Hospital of Shandong University, Jinan 250033, Shandong, China
| | - Feixue Zhang
- Department of Radiology, Ultrasound Division, The Second Hospital of Shandong University, Jinan 250033, Shandong, China
| | - Guangrui Shao
- Department of Radiology, The Second Hospital of Shandong University, Jinan 250033, Shandong, China
| | - Qing Wang
- Department of Radiology, Qilu Hospital of Shandong University, Jinan 250012, Shandong, China
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Lee HJ. Usefulness of subtraction pelvic magnetic resonance imaging for detection of ovarian endometriosis. Yeungnam Univ J Med 2019; 37:90-97. [PMID: 31661751 PMCID: PMC7142026 DOI: 10.12701/yujm.2019.00353] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2019] [Accepted: 09/26/2019] [Indexed: 12/30/2022] Open
Abstract
Background To minimize damage to the ovarian reserve, it is necessary to evaluate the follicular density in the ovarian tissue surrounding endometriosis on preoperative imaging. The purpose of the present study was to evaluate the usefulness of subtraction pelvic magnetic resonance imaging (MRI) to detect ovarian reserve. Methods A subtracted T1-weighted image (subT1WI) was obtained by subtracting unenhanced T1WI from contrast-enhanced T1WI (ceT1WI) with similar parameters in 22 patients with ovarian endometriosis. The signal-to-noise ratio (SNR) in ovarian endometriosis, which was classified into the high signal intensity and iso-to-low signal intensity groups on the T2-weighted image, was compared to that in normal ovarian tissue. To evaluate the effect of contrast enhancement, a standardization map was obtained by dividing subT1WI by ceT1WI. Results On visual assessment of 22 patients with ovarian endometriosis, 16 patients showed a high signal intensity, and 6 patients showed an iso-to-low signal intensity on T1WI. Although SNR in endometriosis with a high signal intensity was higher than that with an iso-to-low signal intensity, there was no difference in SNR after the subtraction (13.72±77.55 vs. 63.03±43.90, p=0.126). The area of the affected ovary was smaller than that of the normal ovary (121.10±22.48 vs. 380.51±75.87 mm2, p=0.002), but the mean number of pixels in the viable remaining tissue of the affected ovary was similar to that of the normal ovary (0.53±0.09 vs. 0.47±0.09, p=0.682). Conclusion The subtraction technique used with pelvic MRI could reveal the extent of endometrial invasion of the normal ovarian tissue and viable remnant ovarian tissue.
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Affiliation(s)
- Hyun Jung Lee
- Department of Obstetrics and Gynecology, School of Medicine, Kyungpook National University, Kyungpook National University Hospital, Daegu, Korea
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Endometriosis-associated ovarian cancer occurs early during follow-up of endometrial cysts. Int J Clin Oncol 2019; 25:51-58. [DOI: 10.1007/s10147-019-01536-5] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2019] [Accepted: 08/25/2019] [Indexed: 12/23/2022]
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