Diagnostic Accuracy of MRI in Diagnosis of Ovarian Endometriosis Keeping Laparoscopic Findings as Gold Standard

Madiha Maryum Azam; Hina Hanif Mughal; Naushaba Malik; Anum zahoor; Mariam Zahir

Madiha Maryum Azam Consultant Radiologist, Benazir Bhutto Hospital, Rawalpindi
Hina Hanif Mughal Associate Professor, Head of Radiology department, Benazir Bhutto Hospital, Rawalpindi
Naushaba Malik Consultant Radiologist, PESSI Hospital, I-12, Islamabad
Anum zahoor Assistant Professor of Radiology, Holy Family Hospital, Rawalpindi
Mariam Zahir Senior Registrar, gynaecology & Obstetrics, Benazir Bhutto Hospital, Rawalpindi

Keywords: endometriosis, gynaecological laproscopy, dysmenorrhea, MRI pelvis female

Abstract

Objectives: To assess the diagnostic accuracy of MRI in the diagnosis of ovarian endometriosis, compared to laparoscopy as the gold standard.

Methodology: This descriptive, cross-sectional validation study was conducted in the Department of Radiology at Holy Family Hospital from April 30, 2019, to October 29, 2019 Rawalpindi. A total of 211 female patients, aged 15-70 years, with suspected ovarian endometriosis were enrolled. All patients underwent an MRI according to the specified protocol, followed by laparoscopy. All patients were enrolled in the study according to inclusion and exclusion criteria. Qualitative variables (history of surgeries) were reported in terms of frequency and percentage, and quantitative variables (age, mean creatinine, mean hemoglobin) were presented as mean ± standard deviation. MRI findings were then compared to laparoscopic findings.

Results: All patients underwent MRI, revealing that 115 were true positives and 7 were false positives. Among the 89 MRI-negative patients, 7 were false negatives, indicating the presence of ovarian endometriosis upon laparoscopy, while 82 were true negatives (p=0.0001). The overall sensitivity, specificity, positive predictive value, negative predictive value, and diagnostic accuracy of MRI for diagnosing ovarian endometriosis compared to laparoscopy as the gold standard were 94.26%, 92.13%, 94.26%, 92.13%, and 93.36%, respectively.

Conclusion: This study concludes that MRI demonstrates the highest diagnostic accuracy for diagnosing ovarian endometriosis among all available diagnostic tools, making it a safe and accurate option for reducing patient morbidity.