The Added Value Of MRI R2* MFGRE Sequence In The Diagnosis Of Pelvic Endometriosis

AIMExploring the added value of magnetic resonance imaging(MRI)R2*MFGRE sequence with multiple fast gradient echo to the diagnosis of endometriosis.Materials and MethodsPatients with pelvic endometriosis and adenomyosis were received MRI examination including R2*MFGRE sequence from September 2017 to December 2019 in our hospital.The lesions were confirmed by surgery and pathology in one month.Forty-six patients with pelvic endometriosis and 32 patients with adenomyosis were included in our study.(1)The number of pelvic endometriosis(ovarian endometrioma,deep infiltrating endometriosis)lesions and the number of adenomyosis lesions confirmed by surgical pathology were counted respectively.(2)The number of ovarian endometrioma,deep infiltrating endometriosis and adenomyosis lesions detected by conventional MRI sequence and conventional MRI sequence combined with R2*MFGRE sequence were counted and compared to the pathological results.The diagnostic sensitivity of the two methods was calculated.(3)The number of hemorrhagic lesions in pelvic endometriosis and adenomyosis detected by FS-T1WI and R2*MFGRE sequence were compared respectively.The number of ectopic endometrial glands detected by T2WI and R2*MFGRE sequences in adenomyosis was compared.(4)The number of pelvic endometriosis lesions and adenomyosis lesions detected by conventional MRI sequences and conventional MRI sequences combined with R2*MFGRE sequence were compared.(5)The R2*values were measured and statistically analyzed for all lesions.(6)Compared with the number of diffient types of endometriosis detected by conventional sequence and conventional sequence combined with R2*MFGRE sequence,the rank sum test of two related samples will be used.The p<0.05 was considered statistically significant.ResultsIn 46 patients with pelvic endometriosis,a total of 77 lesions were confirmed by pathology,including 47 ovarian endometrioma cysts and 30 deep infiltrating endometriosis.Thirty-two patients with 32 lesions of adenomyosis were confirmed by pathology.(2)The diagnostic sensitivity of the conventional sequence was 87.2%(41/47)for ovarian endometrioma and 46.7%(14/30)for deep infiltrating endometriosis.The diagnostic sensitivity of the conventional sequence combined with R2*MFGRE was 100%(47/47)for ovarian endometrioma and 90%(27/30)for deep infiltrating endometriosis.The diagnostic sensitivity of the conventional sequence for adenomyosis was 100%(32/32),which was as same as the diagnostic sensitivity of the conventional sequence combined with R2*MFGRE.(3)In ovarian endometrioma,hemorrhage detected by FS-T1WI and R2*MFGRE sequences were 41 lesions(87.2%)and 47 lesions(100%),respectively.In deep infiltrating endometriosis lesions,hemorrhage detected by FS-T1WI and R2*MFGRE sequences was 14 lesions(46.7%)and 27 lesions(90.0%),respectively.In adenomyosis,hemorrhage detected by T1WI and R2*MFGRE sequences were 27 lesions(84.4%)and 31 lesions(96.8%),respectively.(4)The ectopic glands detected by T2WI and R2*MFGRE were 32 lesions(100%)and 29 lesions(90.6%).The two-correlation sample rank-sum test showed a significant difference between the 2 methods of diagnositic of pelvic endometriosis(p<0.05,z=-4.26).There was no difference in the number of diagnosis of adenomyosis between conventional sequence and conventional sequence combined with R2*MFGRE sequence.(5)The T2*and R2*values were inaccurate and excluded in our study.ConclusionsThe conventional MRI sequence combined with R2*MFGRE sequence could sensitively diagnose endometriosis and locate the lesion.R2*MFGRE sequence,as a supplement to the conventional MRI sequence,could improve the diagnostic sensitivity of MRI for pelvic endometriosis,especially in deep infiltrating endometriosis.The conventional MRI sequence could diagnose endometriosis accurately.R2*MFGRE sequence,as a supplement to the conventional MRI sequence,has no useful to improve diagnostic sensitivity of adenomyosis,but could detect hemorrhage sensitively,which could provide more evidence for the diagnosis of adenomyosis.