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Title: Endometriosis: Does the menstrual cycle affect magnetic resonance (MR) imaging evaluation?
Austin Authors: Botterill, Elissa M;Esler, Stephen J ;McIlwaine, Kate T;Jagasia, Nisha;Ellett, Lenore;Maher, Peter J;Yang, Natalie 
Affiliation: Department of Radiology, Austin Health, Heidelberg, Victoria, Australia
Department of Endosurgery, Mercy Hospital for Women, Heidelberg, Victoria, Australia
Department of Endosurgery, Mater Hospital for Women, South Brisbane, Queensland, Australia
Issue Date: Nov-2015
Date: 2015-08-06
Publication information: European Journal of Radiology 2016; 84(11): 2071-2079
Abstract: PURPOSE: To determine if the menstrual cycle affects MR interpretation in patients with pelvic endometriosis. MATERIALS AND METHODS: Thirty-one patients with either laparoscopically proven endometriosis, or a high clinical suspicion of deep infiltrative endometriosis, were prospectively recruited from May 2008 to October 2009 and January to June 2012. Two pelvic MR scans were performed for pre-operative planning; during menses and the other mid-cycle. Two experienced radiologists independently assessed image quality and disease extent. Both were blinded to patient identity, previous imaging and menstrual status. Interobserver agreement was assessed using the Kappa (k) test. Descriptive statistics were prepared using chi-squared (or Fishers' exact) tests and Mann-Whitney (rank sum) tests to assess for significant differences between menstrual and non-menstrual imaging. RESULTS: Interobserver agreement for image quality was moderate for T2 weighted imaging (k=0.475, p-value <0.001) and substantial for T1 fat saturated imaging (k=0.733, p-value<0.001), with no significant difference in image quality between menstrual and non-menstrual scans (all p-values>0.255). Readers demonstrated at least moderate interobserver agreement for certainty level of endometriosis at site-specific locations, with median k 0.599 (IQR 0.488-0.807). No significant difference in disease extent was observed between menstruating and non-menstruating scans (all p-values>0.05). CONCLUSION: Findings suggest no significant differences in image quality, disease extent or disease severity between menstruating and non-menstruating MR; thus, timing of pelvic MR for assessment of endometriosis need not be influenced by the menstrual cycle.
DOI: 10.1016/j.ejrad.2015.08.003
Journal: European Journal of Radiology
PubMed URL:
Type: Journal Article
Subjects: Deep infiltrating endometriosis
Magnetic Resonance Imaging
Menstrual cycle
Appears in Collections:Journal articles

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