Magnetic Resonance Imaging Features of Endometrial Polyps: Frequency of Occurrence and Interobserver Reliability

Abstract

Objective This study aimed to evaluate magnetic resonance imaging (MRI) features and interobserver agreement of endometrial polyps. Methods After institutional review board approval, our database was searched for women older than 18 years who underwent MRI pelvis and pelvic surgical intervention from 2012 to 2016. Seventy-two patients with polyps and 75 controls composed the study cohort. Two radiologists evaluated the MRIs retrospectively for polyps. Polyp characteristics and enhancement were assessed. Results Sensitivity and specificity of readers 1 and 2 were 59.7% and 88.0%, and 44.4 and 96.0%, respectively. There was moderate agreement for presence of polyps (κ = 0.556, P ≤ 0001), T2 fibrous core, and intratumoral cysts, with slight agreement for T2 signal and enhancement. Polyp size moderately correlated with pathology (κ = 0.465 [P = 0.025] for reader 1, κ = 0.562 [P = 0.029] for reader 2). The most common enhancement was same as myometrium. Conclusion Magnetic resonance imaging is moderately sensitive for detecting endometrial polyps, demonstrating features that are not sensitive but can be specific, with moderate interobserver agreement.