gynecology and obstetrics medical project, gynecology journal, obstetrics, gynecologic oncology, reproductive medicine, gynecological endoscopy, ultrasonography, gynecology articles

Ginekologia i Poloznictwo
ISSN 1896-3315 e-ISSN 1898-0759

The grading of uterine endometriosis by MRI findings


Author(s): Zahraa Abdulhussein Katea* and Kassim Amir Hadi Taj Al-Dean

Background: Endometriosis is the presence of the endometrium outside the uterine cavity accompanies by chronic inflammation or deep pelvic infiltrating affect premenopausal women. Magnetic resonance imaging (MRI) plays an important role in the detection of endometriosis.

Aim: The study aimed to observe the patterns of endometriosis By MRI, to estimate the MRI grades of endometriosis and to achieve the planning of a management approach.

Methods: A prospective study of total of 55 women with history of chronic abdominal pain or menstrual disturbances or pelvic pain were diagnosed as a case of endometriosis enrolled at a period from August 2022 to April 2023 at Department of Radiology, Al-Hillah General Teaching Hospital. Data collected including age, and symptoms. MRI findings include: location of lesion, stage, present of implantation, number of implantation, present of cystation, site, and present of adhesion. MRI (Philips N.V.2021 MRI unit 1.5 Tesla, SRN: 32534) was done for all women in supine position.

Results: The most common reported age group was between (25-35 years) with mean age was (32.22 ± 6.01 years). Regarding MRI findings of endometriosis, the most location of lesion was observed at anterior of pelvis (41.8%). Endometriosis stage III in (60.0%) is common. The severity is mainly moderate in (58.2%). The majority of implantation of endometriosis was seen in deep layer (78.2%). The majority of endometriosis observed with large cystation in (85.5%). Both ovaries involved in most of cases (78.2%). Thes inter-observer agreement Kappa (k) statistic revealed that diagnosis of endometriosis by MRI have better agreement (k= 0.835) than US (k= 0.378) with significant difference.

Conclusion: Younger age women are the most commonly detection with endometriosis. The common MRI findings of endometriosis include anterior segment lesion, stage III, moderately severe, deep seated, large cystic, bilateral and densely adhesion. Statistically, the diagnosis of endometriosis by MRI had better agreement than US.