{"paper_id":"1e279955-9368-48c9-990e-ed1ee475d3fd","body_text":"Abstract\nEndometriosis is a common yet underestimated pathology, defined by the presence of ectopic endometrial tissue. It can be asymptomatic but can also cause chronic pain and/or infertility through various mechanisms. Pelvic ultrasound is the first-line examination for suspected endometriosis. MRI is however the reference examination. The MRI protocol is nonconsensual. However, digestive preparation before the exam is essential, and imaging should include three different T2 planes, a plane in T1 DIXON or T1 and T1 Fat Sat, and imaging of the kidneys to evaluate potential obstruction. Superficial endometriosis is underestimated at imaging but can appear as peritoneal implants and/or adhesions. Adnexal endometriosis is mainly represented by endometriomas that are typical on MRI and may become complicated by infection, rupture, decidualization, and rarely degeneration. Deep pelvic endometriosis is the one most often responsible for symptoms. It typically appears as nodular irregular retractable thickening in hyposignal T2, possibly with cystic of hemorrhagic content, and can affect all components of the pelvis and beyond, including the abdominal wall and diaphragm. The torus and uterosacral ligaments are the most frequently affected sites. A precise cartography of all the lesions using a compartmental approach is mandatory to plan the potential treatment.\nAccess this chapter\nTax calculation will be finalised at checkout\nPurchases are for personal use only\nSimilar content being viewed by others\nReferences\nCoutinho A, Bittencourt LK, Pires CE, Junqueira F, de Oliveira Lima CMA, Coutinho E, et al. MR imaging in deep pelvic endometriosis: a pictorial essay. Radiographics. 2011;31(2):549–67.\nChamié LP, Ribeiro DMFR, Tiferes DA, de Macedo Neto AC, Serafini PC. Atypical sites of deeply infiltrative endometriosis: clinical characteristics and imaging findings. Radiographics. 2018;38(1):309–28.\nBazot M, Bharwani N, Huchon C, Kinkel K, Cunha TM, Guerra A, et al. European society of urogenital radiology (ESUR) guidelines: MR imaging of pelvic endometriosis. Eur Radiol. 2017;27(7):2765–75.\nSiegelman ES, Oliver ER. MR imaging of endometriosis: ten imaging pearls. Radiographics. 2012;32(6):1675–91.\nKhashper A, Addley HC, Abourokbah N, Nougaret S, Sala E, Reinhold C. T2-hypointense adnexal lesions: an imaging algorithm. Radiographics. 2012;32(4):1047–64.\nMcDermott S, Oei TN, Iyer VR, Lee SI. MR imaging of malignancies arising in endometriomas and extraovarian endometriosis. Radiographics. 2012;32(3):845–63.\nGidwaney R, Badler RL, Yam BL, Hines JJ, Alexeeva V, Donovan V, et al. Endometriosis of abdominal and pelvic wall scars: multimodality imaging findings, pathologic correlation, and radiologic mimics. Radiographics. 2012;32(7):2031–43.\nBazot M. Imagerie de la femme: gynécologie, vol. 1. Paris: Lavoisier; 2016.\nAuthor information\nAuthors and Affiliations\nCorresponding author\nRights and permissions\nCopyright information\n© 2025 The Author(s), under exclusive license to Springer Nature Switzerland AG\nAbout this chapter\nCite this chapter\nMandoul, C. (2025). Endometriosis. In: Female Pelvic MRI. Springer, Cham. https://doi.org/10.1007/978-3-031-76684-8_9\nDownload citation\nDOI: https://doi.org/10.1007/978-3-031-76684-8_9\nPublished:\nPublisher Name: Springer, Cham\nPrint ISBN: 978-3-031-76683-1\nOnline ISBN: 978-3-031-76684-8\neBook Packages: MedicineMedicine (R0)","source_license":"CC0","license_restricted":false}