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Updated: Jun 12, 2025

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Radiology State-of-the-art Review: Endometriosis Imaging Interpretation and Reporting.

Wendaline VanBuren1, Myra Feldman1, Anuradha S Shenoy-Bhangle1

  • 1From the Mayo Clinic Rochester, 200 1st Street SW, Rochester, MN 55905 (W.V.B., T.L.B., Z.K., C.C., P.I.C.A.); Cleveland Clinic, Cleveland, Ohio (M.F., C.K., M.P.); Massachusetts General Hospital, Harvard Medical School, Boston, Mass (A.S.S.B., A.K.); University of Michigan, Ann Arbor, Mich (M.D.S.); Mayo Clinic Arizona, Phoenix, Ariz (S.Y., M.Y.); Chamie Imagem da Mulher, São Paulo, Brazil (L.P.C.); University of California San Francisco, San Francisco, Calif (L.G., J.T.R., L.P.); NYU Grossman School of Medicine, New York, NY (N.M.H., A.T., M.T.T.); David Geffen School of Medicine, Los Angeles, Calif (H.D.D.); University of Arizona College of Medicine Phoenix/Banner University Medical Center-Phoenix (R.M.K.); Stanford University School of Medicine, Stanford, Calif (L.S.); Brigham and Women's Hospital, Harvard Medical School, Boston, Mass (K.S.B.); Clinic Izabela Pires Franco, Belém, Brazil (I.V.P.F.); Temerty Faculty of Medicine (P.G.), University of Toronto, Toronto, Ontario, Canada (A.Z.K.); Thomas Jefferson University Hospital, Philadelphia, Pa (L.M.K.); University of Texas Health Science Center at San Antonio, San Antonio, Tex (A.B.); University of Arizona College of Medicine, Banner University Medicine, Tucson, Ariz (H.A.T.); Columbia University Irving Medical Center, New York, NY (S.L.N.); SUNY Upstate Medical University, Syracuse, NY (R.N.); and Department of Radiology, Stanford University School of Medicine, Stanford, Calif (P.J.).

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|September 17, 2024
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Summary
This summary is machine-generated.

Endometriosis imaging requires advanced techniques like MRI and transvaginal ultrasound for accurate diagnosis. Radiologists interpret findings, from mild to advanced stages, including malignancy evaluation, for comprehensive patient care.

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Area of Science:

  • Radiology
  • Medical Imaging
  • Gynecology

Background:

  • Endometriosis affects 190 million globally, often linked to infertility.
  • Characterized by ectopic endometrial-like tissue causing inflammation and fibrosis.
  • Imaging is crucial for diagnosis, especially for deep endometriosis (DE).

Purpose of the Study:

  • To outline imaging strategies for endometriosis, focusing on deep endometriosis.
  • To detail the roles of MRI and transvaginal US in diagnosis.
  • To emphasize a pattern-recognition approach for radiologists.

Main Methods:

  • Dedicated imaging with MRI or advanced transvaginal US based on clinical suspicion.
  • Compartment-based, pattern-recognition approach for pelvic deep endometriosis.
  • Utilizing T1-weighted MRI for hemorrhagic components and transvaginal US for dynamic assessment.

Main Results:

  • MRI offers global pelvic assessment and malignancy evaluation.
  • Transvaginal US provides dynamic assessment of adhesions and bowel invasion depth.
  • T1 hyperintensity on MRI aids specificity but isn't essential for DE diagnosis.

Conclusions:

  • Radiologists must understand the spectrum of endometriosis, from mild to advanced.
  • Imaging interpretation includes evaluating for malignancy.
  • A comprehensive approach using MRI and transvaginal US is key for accurate diagnosis and management.