Diagnostic Accuracy of Ultrasound and MRI in the Mapping of Deep Pelvic Endometriosis Using the International Deep Endometriosis Analysis (IDEA) Consensus

Table 1

Index tests methodology.

		Ultrasound	Magnetic resonance imaging
Technical parameters		Voluson E10 (GE medical Systems, Zipf, Austria)	3 T MR scanner with phased-array pelvic coil (Skyra, Siemens AG, Erlangen, Germany)
		Standard gynecology setting	Slice thickness 3-4 mm with interslice gaps 0.0 mm–1.0 mm
Preparation		No bowel preparation or contrast gel sonography	Fasting for 4 hours
			Butylscopolamine 1 mg i.v.
Technical protocol (standardised for use in every participant)		Transvaginal ultrasound (TV probe 7–9 MHz)	Protocol-part 1 for pelvic DE location
			(1) 2D T2W sequences in sagittal, axial and oblique plane
		Transabdominal ultrasound (curvilinear TA probe 4–7 MHz)	Protocol–part 2 for adnexal lesions
			(2) Dixon technique 2D (T1W images incl. with and without fat suppression sequences)^§
			(3) DWI in axial plane
			(4) Postcontrast 2D T1W with fat suppression (i.v. gadolinium)
Imaged area	Pelvis	TVS	Whole pelvis from iliac crests to pubic bone
	Upper urinary tract	TAS	T2-weighted sequences in coronal plane from symphysis up to kidneys

ESUR recommends 2D T2W sequences for pelvic DE [9]. ^§ESUR recommends 2D T1W sequences for endometriomas with Dixon technique as an alternative to confirm the presence of blood and to rule out a fat-containing lesion (such as dermoids) [9]. ESUR recommended as optional sequences for ‘indeterminate’ adnexal endometriosis (differential diagnosis of pelvic inflammatory disease, malignancy) [9]. 2D, two-dimensional; DE, deep endometriosis; DWI, diffusion-weighted imaging; ESUR, European Society of Urogenital Radiology guidelines [9]; MRI, magnetic resonance imaging; T1W, T1 weighted; T2W, T2 weighted; i.v. intravenous; TAS, transabdominal ultrasound; TVS, transvaginal ultrasound.