• About Us
    • Contact Us
    • Login
    • ObGFirst
  • COVID-19
  • Alerts
  • OB
  • 2T US Atlas
  • The Genome
  • GYN
    • GYN
    • Sexual Health
  • Primary Care
  • Your Practice
  • GrandRounds
  • My Bookshelf
  • Now@ObG
  • Media
About Us Contact Us Login ObGFirst
  • COVID-19
  • Alerts
  • OB
  • 2T US Atlas
  • The Genome
  • GYN
    • GYN
    • Sexual Health
  • Primary Care
  • Your Practice
  • GrandRounds
  • My Bookshelf
  • Now@ObG
  • Media
Grand Rounds

Is Ultrasound or MRI Best When Assessing Colorectal Endometriosis?

image_pdfFavoriteLoadingFavorite

BACKGROUND AND PURPOSE:

  • Intestinal involvement may be seen in 5% to 12% of patients with endometriosis
  • Patients may present with serious GI symptoms and signs (e.g., cyclical rectal bleeding)
  • Transvaginal sonography is the first line imaging technique to detect intestinal endometriosis
  • MRI and rectal endoscopic sonography (RES) are used as second line imaging modalities and also can determine depth of invasion
  • Kim et al. (JMIG, 2017) compared accuracies of magnetic resonance imaging (MRI) and rectal endoscopic sonography (RES) in the prediction of the infiltration depth of colorectal endometriosis

METHODS:

  • Retrospective cohort study
  • Inclusion: Patients with symptomatic deep infiltrating endometriosis of the rectum who had colorectal resection
  • All patients underwent abdominopelvic MRI and RES
  • Performance characteristics and intermethod agreement were calculated

RESULTS:

  • 40 patients were included in this study with a median age of 33 years
  • MRI detection of muscularis layer invasion: PPV (100%)
  • MRI detection of submucosal/mucosal layer involvement: Sensitivity (47%), specificity (81%), PPV(69%), NPV (63%)
  • RES detection of muscularis infiltration: PPV (93%)
  • RES detection of submucosal/mucosal layer involvement: Sensitivity (79%), specificity (48%), PPV (58%), NPV (71%)

CONCLUSION:

  • Compared to RES, MRI is valuable in detecting rectal endometriosis but less accurate in detecting submucosal/mucosal involvement
  • MRI PPV is higher for both muscularis and submucosal/mucosal infiltration
  • However, RES has a better NPV for the detection of submucosal/mucosal infiltration
  • When bowel involvement is detected by MRI, RES is not needed to confirm this finding
  • If bowel infiltration is not detected by MRI, RES is necessary to rule out this finding (especially if a patient is symptomatic)

Learn More – Primary Sources:

Magnetic Resonance Imaging Compared with Rectal Endoscopic Sonography for the Prediction of Infiltration Depth in Colorectal Endometriosis

image_pdfFavoriteLoadingFavorite

< Previous
All Grand Rounds Posts
Next >

Related ObG Topics:

Evaluation and Treatment of Endometriosis
Does the Oral GnRH Antagonist Elagolix Improve Endometriosis-Associated Pain?
Laparoscopic Excision vs. Ablation for Treating Endometriosis-Associated Pain

Sections

  • COVID-19
  • Alerts
  • OB
  • GYN
    • GYN
    • Sexual Health
  • 2T US Atlas
  • The Genome
  • Primary Care
  • Your Practice
  • Grand Rounds
  • My Bookshelf
  • Now@ObG
  • Media

Are you an
ObG Insider?

Get specially curated clinical summaries delivered to your inbox every week for free

  • Site Map/
  • © ObG Project/
  • Terms and Conditions/
  • Privacy/
  • Contact Us/
© ObG Project
SSL Certificate


  • Already an ObGFirst Member?
    Welcome back

    Log In

    Want to sign up?
    Get guideline notifications
    CME Included

    Sign Up

Get Guideline Alerts Direct to Your Phone
Try ObGFirst Free!

Sign In

Lost your password?

Sign Up for ObGFirst and Stay Ahead

  • - Professional guideline notifications
  • - Daily summary of a clinically relevant
    research paper
  • - Includes 1 hour of CME every month

ObGFirst Free Trial

Already a Member of ObGFirst®?

Please log in to ObGFirst to access the 2T US Atlas

Password Trouble?

Not an ObGFirst® Member Yet?

  • - Access 2T US Atlas
  • - Guideline notifications
  • - Daily research paper summaries
  • - And lots more!
ObGFirst Free Trial

Media - Internet

Computer System Requirements

OBG Project CME requires a modern web browser (Internet Explorer 10+, Mozilla Firefox, Apple Safari, Google Chrome, Microsoft Edge). Certain educational activities may require additional software to view multimedia, presentation, or printable versions of their content. These activities will be marked as such and will provide links to the required software. That software may be: Adobe Flash, Apple QuickTime, Adobe Acrobat, Microsoft PowerPoint, Windows Media Player, or Real Networks Real One Player.

Disclosure of Unlabeled Use

This educational activity may contain discussion of published and/or investigational uses of agents that are not indicated by the FDA. The planners of this activity do not recommend the use of any agent outside of the labeled indications.

The opinions expressed in the educational activity are those of the faculty and do not necessarily represent the views of the planners. Please refer to the official prescribing information for each product for discussion of approved indications, contraindications, and warnings.

Disclaimer

Participants have an implied responsibility to use the newly acquired information to enhance patient outcomes and their own professional development. The information
presented in this activity is not meant to serve as a guideline for patient management. Any procedures, medications, or other courses of diagnosis or treatment discussed or suggested in this activity should not be used by clinicians without evaluation of their patient’s conditions and possible contraindications and/or dangers in use, review of any applicable manufacturer’s product information, and comparison with recommendations of other authorities.

Jointly provided by

NOT ENOUGH CME HOURS

It appears you don't have enough CME Hours to take this Post-Test. Feel free to buy additional CME hours or upgrade your current CME subscription plan

Subscribe

JOIN OBGFIRST AND GET CME/CE CREDITS

One of the benefits of an ObGFirst subscription is the ability to earn CME/CE credits from the ObG entries you read. Tap the button to learn more about ObGFirst

Learn More
Leaving ObG Website

You are now leaving the ObG website and on your way to PRIORITY at UCSF, an independent website. Therefore, we are not responsible for the content or availability of this site