Evaluation of the usefulness of the MRI jelly method for diagnosing complete cul-de-sac obliteration

Biomed Res Int. 2014;2014:437962. doi: 10.1155/2014/437962. Epub 2014 Apr 10.

Abstract

Objective: We conducted a single-center study to evaluate the usefulness of the magnetic resonance (MR) imaging jelly method for diagnosing endometriosis-associated adhesions in the Pouch of Douglas.

Methods: Thirty women with menstrual pain, dyspareunia, and chronic pelvic pain were enrolled in the study. All had been scheduled for laparoscopic surgery on the basis of pelvic and/or ultrasonographic (US) evaluation. All underwent MR imaging both with and without application of US jelly to the vagina and rectum. The images were compared and analyzed postsurgically in a random and blinded fashion by a radiology specialist and a radiology fellow. The radiologists' interpretations of the images were compared to the surgical findings recorded on DVDs.

Results: Adhesions in the Pouch of Douglas were found in 21 patients. The sensitivity and specificity of MR imaging without jelly administration were 85.7% and 55.6%, respectively, for the specialist and 81.0% and 55.6%, respectively, for the fellow; with jelly administration, values were 95.2% and 88.9% for the specialist and 90.5% and 66.7% for the fellow. Opacity produced by the jelly increased the sensitivity and specificity for both radiologists.

Conclusion: The MRI jelly method is a potentially useful, beneficial, and simple approach for diagnosing Pouch of Douglas adhesions.

MeSH terms

  • Adult
  • Douglas' Pouch / pathology*
  • Endometriosis / diagnosis*
  • Endometriosis / pathology
  • Female
  • Humans
  • Magnetic Resonance Imaging / methods*
  • Middle Aged
  • ROC Curve
  • Young Adult