Kim A, et al. – The accuracies of magnetic resonance imaging (MRI) and rectal endoscopic sonography (RES) in the prediction of the infiltration depth of colorectal endometriosis is compared in this study. In the current study, MRI is useful for detecting endometriosis of the rectum but is less accurate in detecting submucosal/mucosal involvement than RES. Magnetic resonance imaging was not successful for the preoperative determination of segmental resection versus a more conservative approach. When bowel involvement is detected by MRI, RES is not essential. At the point when symptoms propose deep infiltrating endometriosis (DIE) in patients without intestinal lesions detected by MRI, RES is essential to exclude bowel invasion.

Methods

• For this study, they designed a retrospective cohort study (Canadian Task Force classification II–2).
• This study was conducted at university teaching hospital.
• Total 40 patients with symptomatic deep infiltrating endometriosis (DIE) of the rectum who underwent colorectal resection were incorporated.
• All patients underwent an abdominopelvic MRI and RES preoperatively to evaluate infiltration depth of colorectal endometriosis, and segmental resection of the rectosigmoid by laparoscopy was performed if RES exhibited bowel invasion.
• Sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), positive and negative likelihood ratios (LRs), and intermethod agreement were figured for DIE muscularis and submucosal/mucosal infiltration, affirmed by histopathological examination.

Results

• For the MRI detection of DIE muscularis infiltration, the sensitivity, specificity, PPV, NPV, and negative LR were 68%, 100%, 100%, 20%, and 0.32, respectively.
• For the MRI detection of DIE submucosal/mucosal involvement, the sensitivity, specificity, PPV, NPV, and positive and negative LRs were 47%, 81%, 69%, 63%, 2.49 and 0.65, respectively.
• The PPV of RES detection of DIE muscularis infiltration was 93%. For the RES detection of DIE submucosal/mucosal layers, the sensitivity, specificity, PPV, NPV, and positive and negative LRs were 79%, 48%, 58%, 71%, 1.51 and 0.44, respectively.