{"paper_id":"1b06592d-6998-4199-a54e-f5b579d34ebd","body_text":"ECR 2026 / C-24747\nFrom ports to pixels: Reimagining the AAGL Endometriosis Classification through Imaging\nCongress:\nECR 2026\nPoster Number:\nC-24747\nType:\nEducational Exhibit\nKeywords:\nAnatomy, Genital / Reproductive system female, Pelvis, MR, Diagnostic procedure, Education, Structured reporting, Education and training\nAuthors:\nJ. E. Mourao Santos, D. D. C. Martins, A. Melloni, G. Vianna, A. Morganti, F. Braga, B. J. A. Wood, B. Muszkat, F. Muszkat\nDOI:\n10.26044/ecr2026/C-24747\nLearning objectives\nTo review and illustrate the anatomical compartments defined in the American Association of Gynecologic Laparoscopists (AAGL) 2021 endometriosis classification.\nTo propose an MRI-based scoring system equivalent to the surgical classification, adapting surgical compartments to imaging-based compartments.\nTo demonstrate how applying this MRI-adapted AAGL score can reduce descriptive variability and enhance communication between radiologists and multidisciplinary surgical teams.\nTo present a structured reporting model incorporating the main sites of endometriotic involvement and the proposed score, aiming to facilitate diagnosis and preoperative staging.\nBackground\nEndometriosis is a chronic inflammatory gynecological disease that affects approximately 10% of women of reproductive age, frequently associated with chronic pelvic pain, dysmenorrhea, dyspareunia, bowel or bladder dysfunction, and infertility, causing a significant impact on quality of life. [1]Magnetic resonance imaging (MRI) is the leading imaging modality for preoperative mapping, enabling accurate assessment of lesion site, depth, and extent, and serving as a valuable tool to estimate surgical complexity. [1]\nFindings and procedure details\nMRI PREPARATION AND PROTOCOLA model MRI protocol is presented in Figure 1. [Fig 1]“TYPES OF ENDOMETRIOSIS”1. OVARIAN ENDOMETRIOSISMRI findings: unilocular or multilocular cysts containing hemoglobin degradation products at variable stages, demonstrating hyperintensity on T1-weighted images and hypointensity on T2-weighted images (T2 shading). [2] [Fig 10]2. SUPERFICIAL ENDOMETRIOSISThese are small lesions on the peritoneal surface, better visualized during laparoscopy. On MRI, they appear as foci of hyperintensity on T1-weighted images with fat suppression, generally without corresponding signal on T2-weighted sequences. [5]3. DEEP ENDOMETRIOSISDeep endometriosis is defined...\nConclusion\nImplementing an MRI-based score aligned with the AAGL 2021 classification and integrated into a structured report could standardize multidisciplinary communication, improve surgical planning, and enhance preoperative staging of endometriosis, fostering advances in both clinical practice and education in pelvic radiology.\nPersonal information and conflict of interest\nJ. E. Mourao Santos:\nNothing to disclose\nD. D. C. Martins:\nNothing to disclose\nA. Melloni:\nNothing to disclose\nG. Vianna:\nNothing to disclose\nA. Morganti:\nNothing to disclose\nF. Braga:\nNothing to disclose\nB. J. A. Wood:\nNothing to disclose\nB. Muszkat:\nNothing to disclose\nF. Muszkat:\nNothing to disclose\nReferences\n[1] ROUSSET, P.; FLORIN, M.; BHARWANI, N.; TOUBOUL, C.; MONROC, M.; GOLFIER, F.; et al. Deep pelvic infiltrating endometriosis: MRI consensus lexicon and compartment-based approach from the ENDOVALIRM group. Diagnostic and Interventional Imaging, v. 104, n. 3, p. 95–112, 2023. DOI: 10.1016/j.diii.2022.09.004.[2] VANBUREN, W.; FELDMAN, M.; SHENOY BHANGLE, A. S.; SAKALA, M. D.; YOUNG, S.; CHAMIE, L. P.; et al. Radiology state of the art review: Endometriosis imaging interpretation and reporting. Radiology, v. 312, n. 3, e233482, 2024. DOI: 10.1148/radiol.233482.[3] ABRÃO, M. S.; ANDRES, M....","source_license":"CC0","license_restricted":false}