Endometriosis: 10 Keys Points for MRI

Manganaro, Lucia; Anastasi, Emanuela; Vinci, Valeria; Saldari, Matteo; Bernardo, Silvia; Sollazzo, Paolo; Ballesio, Laura; Fuggetta, Eliana; Giancotti, Antonella; Porpora, Maria Grazia

doi:10.5301/je.5000209

Cited by 8 publications

(6 citation statements)

References 67 publications

(126 reference statements)

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“…The typical findings are the medialisation of both ligaments (“V” shape appearance) and the focal or global ligament thickening (higher than 6 mm), appearing as hypo- intense image on T1 and T2-W sequences. ( Manganaro et al 2015 ). Other indirect images are less frequently seen ( Table VIII ).…”

Section: Indirect and Atypical Signals According To Anatomical Compar...mentioning

confidence: 99%

Indirect and atypical imaging signals of endometriosis: A wide range of manifestations

Smith¹,

Cabrera²,

Trippia³

et al. 2021

Facts Views Vis ObGyn

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Background: Whilst some imaging signs of endometriosis are common and widely accepted as ‘typical’, a range of ‘subtle’ signs could be present in imaging studies, presenting an opportunity to the radiologist and the surgeon to aid the diagnosis and facilitate preoperative surgical planning. Objective: To summarise and analyse the current information related to indirect and atypical signs of endometriosis by ultrasound (US) and magnetic resonance imaging (MRI). Methods: Through the use of PubMed and Google scholar, we conducted a comprehensive review of available articles related to the diagnosis of indirect signs in transvaginal US and MRI. All abstracts were assessed and the studies were finally selected by two authors. Results: Transvaginal US is a real time dynamic exploration, that can reach a sensitivity of 79-94% and specificity of 94%. It allows evaluation of normal sliding between structures in different compartments, searching for adhesions or fibrosis. MRI is an excellent tool that can reach a sensitivity of 94% and specificity of 77% and allows visualisation of the uterus, bowel loop deviation and peritoneal inclusion cysts. It also allows the categorisation and classification of ovarian cysts, rectovaginal and vesicovaginal septum obliteration, and small bowel endometriotic implants. Conclusion: The use of an adequate mapping protocol with systematic evaluation and the reporting of direct and indirect signs of endometriosis is crucial for detailed and safe surgical planning.

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Section: Indirect and Atypical Signals According To Anatomical Compar...mentioning

confidence: 99%

Indirect and atypical imaging signals of endometriosis: A wide range of manifestations

Smith¹,

Cabrera²,

Trippia³

et al. 2021

Facts Views Vis ObGyn

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“…33 According to ESUR, basic MR protocol for imaging of endometriosis should include at least two orthogonal T 2 planes (axial and most commonly sagittal), T 1 sequence with and without fat suppression, and optional addition of DWI, contrast-enhanced sequence after Gd injection, susceptibility weighted imaging (SWI) and HASTE sequences. 34 Endometriomas typically show high signal intensity on T 1 images and a "shading" sign on T 2 images, caused by old blood products, which contain extremely high iron and protein concentrations, accompanied by variable restriction of diffusion 35 (Figure 6). Differential diagnosis of endometriomas includes hemorrhagic cysts, which usually have lower signal intensity on T 1 images and absence of a "shading" sign, and cystic teratoma, for which fat suppression is a problem-solving sequence.…”

Section: Imagingmentioning

confidence: 99%

“…Differential diagnosis of endometriomas includes hemorrhagic cysts, which usually have lower signal intensity on T 1 images and absence of a "shading" sign, and cystic teratoma, for which fat suppression is a problem-solving sequence. 35 ( Figure 7)…”

Section: Imagingmentioning

confidence: 99%

Systematic radiological approach to utero-ovarian pathologies

Nikolić

Spasić

et al. 2019

The British Journal of Radiology

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“…2 Imaging methods such as transvaginal ultrasound and magnetic resonance allow the precise anatomical localization of some forms of endometriosis. 3,4 Although accurate for ovarian endometrioma and deep infiltrating lesions, these imaging methods are operator-dependent, require a highly specialized training, and fail to detect superficial peritoneal endometriotic implants. 5,6 Decades of research have not led to a reliable biomarker for the non-invasive detection of endometriosis.…”

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confidence: 99%