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01-07-2019 | Magnetic Resonance Imaging | General Gynecology

The ENZIAN score as a preoperative MRI-based classification instrument for deep infiltrating endometriosis

Authors: Laurin Burla, David Scheiner, Eleftherios Pierre Samartzis, Stefan Seidel, Markus Eberhard, Daniel Fink, Andreas Boss, Patrick Imesch

Published in: Archives of Gynecology and Obstetrics | Issue 1/2019

Abstract

Purpose

Comparison of preoperative magnetic resonance imaging (MRI) with intraoperative findings in patients with deep infiltrating endometriosis (DIE) by means of the ENZIAN score.

Methods

This retrospective two-center study includes 63 patients with deep infiltrating endometriosis, who underwent surgery between 2012 and 2016 at both the University Hospital of Zurich and the Cantonal Hospital of Schaffhausen. Inclusion criteria were a preoperative pelvic MRI and intraoperative or bioptic confirmation of DIE. The preoperative MRI findings were compared with the intraoperative results by means of the ENZIAN score. Furthermore, the various MRI sequences were analyzed for their diagnostic value based on a Likert scale.

Results

Sensitivity and negative predictive values of MRI confirmed by surgery were 95.2% and 91.7% (lesions in the vaginal/rectovaginal space), 78.4% and 56% (uterosacral ligaments), 91.4% and 89.7% (rectum/sigmoid colon), 57.1% and 94.1% (myometrium), 85.7% and 98.3% (bladder), and 73.3% and 92.2% (intestine), respectively. T2 axial and sagittal MRI sequences in combination with a T1 sequence were diagnostically sufficient.

Conclusions

The MRI-based ENZIAN score correlates well with the intraoperative findings, enabling a better planning of the surgical procedure for patients and physicians. However, considerable difficulty and a poorer comparability result from the variations in sequences used in the detection of this multifaceted disease. Therefore, a standardization of MRI protocols used in the detection of DIE will be a crucial step towards increased diagnostic validity and the ENZIAN score may be used as an anatomical land map and valuable communication tool between radiologists and gynecologists.

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Title: The ENZIAN score as a preoperative MRI-based classification instrument for deep infiltrating endometriosis
Authors: Laurin Burla
David Scheiner
Eleftherios Pierre Samartzis
Stefan Seidel
Markus Eberhard
Daniel Fink
Andreas Boss
Patrick Imesch
Publication date: 01-07-2019
Publisher: Springer Berlin Heidelberg
Keywords: Magnetic Resonance Imaging
Magnetic Resonance Imaging
Endometriosis
Published in: Archives of Gynecology and Obstetrics / Issue 1/2019
Print ISSN: 0932-0067
Electronic ISSN: 1432-0711
DOI: https://doi.org/10.1007/s00404-019-05157-1

ACC 2024 Congress

Springer Medicine

The ENZIAN score as a preoperative MRI-based classification instrument for deep infiltrating endometriosis

Abstract

Purpose

Methods

Results

Conclusions

ACC 2024 Congress

Springer Medicine

Abstract

Purpose

Methods

Results

Conclusions

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