European society of urogenital radiology (ESUR) guidelines: MR imaging of pelvic endometriosis

Bazot, Marc; Bharwani, Nishat; Huchon, Cyrille; Kinkel, Karen; Cunha, Teresa Margarida; Guerra, Adalgisa; Manganaro, Lucia; Buñesch, Laura; Kido, Aki; Togashi, Kaori; Thomassin‐Naggara, Isabelle; Rockall, Andrea

doi:10.1007/s00330-016-4673-z

Cited by 213 publications

(198 citation statements)

References 79 publications

(128 reference statements)

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“…This is also supported by previous ESUR guidelines [3, 7, 8]. The rationale behind fasting is to reduce the risks from vomiting occurring as a reaction to the contrast medium injection as well as to reduce bowel motion artifacts.…”

Section: Discussionsupporting

confidence: 59%

European Society of Urogenital Radiology (ESUR) Guidelines: MR Imaging of Leiomyomas

Weston

Nougaret

et al. 2018

Eur Radiol

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ObjectiveThe aim of the Female Pelvic Imaging Working Group of the European Society of Urogenital Radiology (ESUR) was to develop imaging guidelines for MR work-up in patients with known or suspected uterine leiomyomas.MethodsGuidelines for imaging uterine leiomyomas were defined based on a survey distributed to all members of the working group, an expert consensus meeting at European Congress of Radiology (ECR) 2017 and a critical review of the literature.ResultsThe 25 returned questionnaires as well as the expert consensus meeting have shown reasonable homogeneity of practice among institutions. Expert consensus and literature review lead to an optimized MRI protocol to image uterine leiomyomas. Recommendations include indications for imaging, patient preparation, MR protocols and reporting criteria. The incremental value of functional imaging (DWI, DCE) is highlighted and the role of MR angiography discussed.ConclusionsMRI offers an outstanding and reproducible map of the size, site and distribution of leiomyomas. A standardised imaging protocol and method of reporting ensures that the salient features are recognised. These imaging guidelines are based on the current practice among expert radiologists in the field of female pelvic imaging and also incorporate essentials of the current published MR literature of uterine leiomyomas.Key Points• MRI allows comprehensive mapping of size and distribution of leiomyomas.• Basic MRI comprise T2W and T1W sequences centered to the uterus.• Standardized reporting ensures pivotal information on leiomyomas, the uterus and differential diagnosis.• MRI aids in differentiation of leiomyomas from other benign and malignant entities, including leiomyosarcoma.Electronic supplementary materialThe online version of this article (10.1007/s00330-017-5157-5) contains supplementary material, which is available to authorized users.

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Section: Discussionsupporting

confidence: 59%

European Society of Urogenital Radiology (ESUR) Guidelines: MR Imaging of Leiomyomas

Weston

Nougaret

et al. 2018

Eur Radiol

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“…MRI provides excellent high-contrast and high-resolution morphological images of the human prostate (3). The guidelines for routine diagnosis and treatment of prostate disease outlined by the European Society of Urogenital Radiology currently recommend examination by prostate multi-parametric MRI, including the uses of T1-weighted imaging (T1WI), T2-weighted imaging (T2WI) and diffusion-weighted imaging (DWI) (4,5). Preoperative evaluation of PCa aggressiveness is a prerequisite to offer personalized treatment options.…”

Section: Introductionmentioning

confidence: 99%

Correlation of diffusion tensor imaging parameters and Gleason scores of prostate cancer

et al. 2017

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Abstract. The aim of the present study was to explore the association between the parameters of diffusion tensor imaging (DTI), including fractional anisotropy (FA) values, apparent diffusion coefficient (ADC) values and the diffusion tensor tractography (DTT) map, with the Gleason score of prostate cancer (PCa). A retrospective study of 50 cases of PCa confirmed by biopsy or surgical pathology was performed. Conventional magnetic resonance imaging and DTI scans were conducted in these cases. The 50 cases of PCa were divided into three groups, including low, intermediate and high grade, according to the Gleason score. Post-DTI processing was performed using Neuro 3D software, in order to measure the FA and ADC values, and map the prostate fibers. Differences in FA and ADC values among the various PCa groups were examined using analysis of variance, while the correlation of FA and ADC values with the Gleason score was studied using Pearson correlation analysis. The obtained DTT map clearly demonstrated the spatial structure of the prostate fibers. The fibers of the cancer area were dense without interruption in the low-grade group, sparse and disordered in the intermediate-grade group, and were disordered, sparse or even absent in the high-grade group. The FA values were 0.284±0.313, 0.293±0.347 and 0.369±0.347, respectively, with statistically significant differences observed among the three groups (F=234.533; P<0.05) and between each group (P<0.05). In addition, the FA value of PCa was positively correlated with the Gleason score (r=0.884; P<0.05). The ADC values of the low-, intermediate-and high-grade groups were 1.070±0.072x10 , respectively, which demonstrated statistically significant differences among the three groups (F=49.987; P<0.05) and between each group (P<0.05). Furthermore, the ADC values of PCa were negatively correlated with Gleason score (r=-0.810; P<0.05). In conclusion, there was an association between DTI parameters and Gleason score, which may be used to evaluate the grading and prognosis of PCa.

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“…Sometimes, mild hyperintense foci on T2-weighted images may be present, corresponding to dilated endometrial glands. Gadolinium injection does not improve the diagnosis of bladder wall endometriosis (8) …”

Section: Bladdermentioning

confidence: 99%

“…However, the recent European Society of Urogenital Radiology (ESUR) guidelines for MRI of pelvic endometriosis suggest no recommendation for timing of MRI in relation to the menstrual cycle in the evaluation of deep pelvic endometriosis. (8). Superficial endometriotic lesions and endometrioma appear hyperintense on T1-weighted images when recent, or hypointense on T1-weighted images and heterogeneously hyperintense on T2-weighted images when old; however, superficial implants are rarely seen on MRI.…”

Section: Mri: Technical Requirements and Evaluationmentioning

confidence: 99%

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Shining light in a dark landscape: MRI evaluation of unusual localization of endometriosis

Gui¹,

Valentini²,

Ninivaggi³

et al. 2017

Diagn Interv Radiol

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Endometriosis is a systemic disease that affects about 10% to 20% of women during their reproductive age, characterized by the presence of endometrial glands and stroma outside the uterine cavity (1). Endometriosis lesions are characterized by intralesional recurrent bleeding during menses, because of the hormonal responsiveness of ectopic endometrial tissue, with resulting fibrosis. Typical symptoms are cyclic or chronic pelvic pain, dysmenorrhea, dyspareunia, and pain during defecation or urinating. Unusual endometriosis localizations may be associated with more specific symptoms depending on the site of the localization. According to Siegelmen et al. (2) there are three forms of pelvic endometriosis: (a) superficial peritoneal lesions; (b) ovarian endometrioma; (c) deep (or solid infiltrating) endometriosis (DIE), which is histologically identified as a lesion that extends more than 5 mm into the subperitoneal space and/or affects the wall of organs in the pelvis and ligaments. In superficial endometriosis, superficial plaques are disseminated across the peritoneum, adnexa and ligaments of the uterus; these noninvasive implants are well recognized at laparoscopy and not often detectable with magnetic resonance imaging (MRI). Laparoscopy is the standard of reference for the diagnosis of endometriosis but nodules covered by adhesions and subperitoneal disease are difficult to study. Pouch of Douglas, uterosacral ligaments, torus uterinus, and bowel are the most frequent sites of deep pelvic endometriosis localization. Atypical pelvic localizations of endometriosis can occur at level of the cervix, vagina, round ligaments, ureter, and nerves. Rare extrapelvic endometriosis implants can also be localized in the upper abdomen, subphrenic fold, or subcutaneous fat tissue of the abdominal wall. The focus of this review is to describe atypical pelvic and abdominal localizations of endometriosis that should be known by radiologists in order to correctly identify and characterize these lesions on MRI. Moreover, we describe the MRI appearance of the implants at specific sites and review the literature with special attention to imaging reports and description. 272From the Institute of Radiology, Diagnostic Area (B.G.  benedetta.gui@policlinicogemelli.it, A.L.V., V.N., M.M., V.Z., P.P.G., F.C., L.B.) and the Institute of Obstetrics and Gynecology, Female Health Area (M.G.), Catholic University of the Sacred Heart, Agostino Gemelli Hospital, Rome, Italy; "F. Miulli" Regional General Hospital (M.G.), Acquaviva delle Fonti, Bari, Italy. ABSTRACTEndometriosis is a disease distinguished by the presence of endometrial tissue outside the uterine cavity with intralesional recurrent bleeding and resulting fibrosis. The most common locations for endometriosis are the ovaries, pelvic peritoneum, uterosacral ligaments, and torus uterinus. Typical symptoms are secondary dysmenorrhea and cyclic or chronic pelvic pain. Unusual sites of endometriosis may be associated with specific symptoms depending on the localization. Atypical pelv...

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European society of urogenital radiology (ESUR) guidelines: MR imaging of pelvic endometriosis

Cited by 213 publications

References 79 publications

European Society of Urogenital Radiology (ESUR) Guidelines: MR Imaging of Leiomyomas

European Society of Urogenital Radiology (ESUR) Guidelines: MR Imaging of Leiomyomas

Correlation of diffusion tensor imaging parameters and Gleason scores of prostate cancer

Shining light in a dark landscape: MRI evaluation of unusual localization of endometriosis

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