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Complementary Roles of Rectal Magnetic Resonance Imaging and Endoscopic Ultrasound in the Preoperative Assessment of
Wen Zhang1, Xiaocui Zhang1, Hong Zhang2
1Department of Obstetrics and Gynecology, Shengjing Hospital of China Medical University (Drs. W. Zhang, X. Zhang, G. Wang), Shenyang, Liaoning, China; National Clinical Research Sub-Center for Obstetric & Gynecologic Diseases, Shengjing Hospital of China Medical University (Drs. W. Zhang, X. Zhang, G. Wang), Shenyang, Liaoning, China; Liaoning Clinical Research Center for Gynecologic Diseases, Shengjing Hospital of China Medical University (Drs. W. Zhang, X. Zhang, G. Wang), Shenyang, Liaoning, China.
Objective:
To investigate the complementary roles of rectal magnetic resonance imaging and endoscopic ultrasound in the preoperative assessment of rectal deep endometriosis (DE).
Design:
Retrospective, cross-sectional study.
Setting:
Shengjing Hospital of China Medical University.
Patients:
A total of 59 rectal DE patients between January 2020 and September 2025. All patients underwent preoperative endoscopic ultrasonography (EUS) and enhanced rectal magnetic resonance imaging (MRI) examinations, followed by laparoscopic surgery and pathological examination, with complete surgical, pathological, and imaging data.
Interventions:
Taking the findings of laparoscopic exploration and postoperative pathological results as the gold standard, the diagnostic efficacy of EUS or rectal MRI for rectal DE, as well as the coincidence rate and differences between the two examination methods in the key preoperative evaluation indicators of rectal DE, was evaluated.
Measurements And Main Results:
The results showed that both examination methods had good diagnostic efficacy for rectal DE. The key preoperative evaluation indicators included lesion size, lesion location, distance from the lowest edge of the lesion to the anal verge, infiltration depth, single/multiple lesions, and the presence of multiple organ involvement. For most indicators, there were statistically significant differences in the coincidence rates evaluated by the two methods, with poor consistency for the same indicator, and only moderate consistency was achieved in the evaluation of the lesion size. This indicates that the two examination methods have different focuses and information differences in the evaluation of these key indicators, suggesting that the complementarity of the two methods should be comprehensively considered in clinical applications.
Conclusion:
Rectal MRI and EUS are both important imaging tools for rectal DE, each with its own advantages. However, they should be used as complementary imaging tools and may offer more comprehensive preoperative information to help select optimal surgical strategies for patients with rectal DE.
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