79 Non-invasive detection of endometriosis implants with MRI and patient reported outcomes

Abstract

To understand the characteristics of patients with superficial endometriosis implants detected on MRI. A retrospective chart review of 10 years of MRIs noting “endometriosis” within the report. MRIs done by radiologists trained in detection of superficial endometriosis. There were 161 MRI reports over a 10-year period with 100 meeting criteria for MRI evidence of endometriosis and 50 with superficial endometriosis implants. Of the 100 patients, 50 had superficial implants; 18 patients had superficial implants only, 32 patients had other findings on MRI (e.g., endometriomas). In patients with superficial implants, 61% had one, 16% two, 6% three, and 16% innumerable implants noted on MRI. The most common location of superficial implants was the ovary (56%), followed by the abdominal wall (11%), peritoneum (6%), bladder (6%), and bowel (6%). The average age of patients with only superficial implants was 37 (SD = 7) and BMI was 26 (SD = 7). 28% were white, 11% black, 9% Asian, 52% were other. 55.6% had some medical comorbidity. There was no significant difference in race, age, BMI, and medical comorbidities, between the two groups. The most common medical comorbidity of the superficial cases was anxiety or depression (44.4%) followed by asthma (17%) and autoimmune disease (17%). Patients with only superficial implants were significantly more likely to have anxiety or depression (χ2 [1, N = 100] = 8.198, P < 0.01) than patients with additional MRI findings. MRI capabilities have now expanded to include detection of superficial endometriosis, but the characteristics of patients with these lesions is unknown. Our study has shown a substantial proportion (18%) of MRIs are now discovering only superficial lesions. These patients seem to be similar in demographics to those with other MRI findings, however in our population they were significantly more likely to have anxiety and depression.