PELVIC ENDOMETRIOSIS - DETECTION AND DIAGNOSIS WITH CHEMICAL-SHIFT MR-IMAGING

Fat-saturation magnetic resonance (MR) imaging for detection and chara cterization of pelvic endometriosis was prospectively investigated in 35 women with a clinical diagnosis of the disease. Large endometrioma was diagnosed when the lesion was larger than 1 cm in diameter and hyp erintense on T1- and T2-weighted images. Small endometrioma was diagno sed when a well-demarcated hyperintense lesion less than 1 cm in diame ter was seen on T1-weighted or fat-saturated T1-weighted images. Surge ry performed after MR imaging revealed a normal pelvis in six patients , endometriosis in 26 (33 large and 19 small endometriomas), and other cystic lesions in three. Conventional T1- and T2-weighted imaging acc urately demonstrated 27 of 33 large endometriomas and two of 19 small endometriomas. Fat-saturation T1-weighted imaging in combination with conventional technique accurately demonstrated 30 of 33 large and nine of 19 small endometriomas. Diagnostic accuracy was improved with addi tion of fat-saturated images, so their use together with conventional images is recommended in assessment of endometriosis.