Endometriosis diagnostics-Fusion MRI-ultrasound

Endometriosis is defined as the presence of endometrial glands and stroma at
extra uterine sites. Prevalence is estimated at 5-10% in women of reproductive
age and up to 50% in women with infertility. The average time from the first
symptoms until the diagnosis of endometriosis is 7-8 years.
Patients with endometriosis and a frozen pelvis and/or nodules in the bowel
and/or nodules in the bladder are best managed in a multidisciplinary team. A
correct diagnosis of endometriosis is necessary.
Transvaginal ultrasound and Magnetic Resonance Imaging both have advantages and
disadvantages. Fusion MRI-ultrasound may be more accurate in the diagnosis of
endometriosis and hopefully reduce the time between the first symptoms and
diagnosis.

To determine the feasibility of Fusion MRI-ultrasound for the uterus and ovary.
To determine if Fusion MRI-ultrasound is more accurate for the diagnosis of
endometiosis then MRI or ultrasound alone.

Pilot:
Inclusion of 10 patients with a MRI for a benign disease. Within 3 weeks of the
MRI a transvaginal ultrasound according to the fusion protocol will be
performed: first, the MRI and ultrasound will be calibrated. Then, a few
anatomical landmarks will be chosen (cervix, urethra, rectum, ovary) and the
distance from the landmark to the calibrationpoint will be measured. After 5
minutes, the measurement will be repeated to determine the reproducibility.
Study:
Inclusion of 25 patients with a MRI for endometriosis preoperatively. Within 3
weeks of the MRI scan a transvaginal ultrasound according to the fusion
protocol will be performed. Calibration as above. Then, every spot suspected
for endometriosis on conventional ultrasound or MRI will be reassessed:
endometriosis yes/no.

1 extra visit to the outpatient clinic. During that visit a transvaginal
ultrasound will be performed.