{"paper_id":"48f36bf3-c908-4e6d-be23-ce253f412907","body_text":"Abstract\nVaginal endometriosis is often associated with the posterior infiltrative involvement of the uterosacral ligaments, torus uterinum, rectovaginal septum, rectum, and parametrium. Diagnosing this disease location during a preoperative workup is crucial for several reasons: (1) Patients counseling patients on the surgical procedure and the postoperative period and (2) planning the surgery, including the risk of digestive derivation with a stoma and with concomitant rectum involvement. Vaginal endometriosis diagnosis can be challenging in imaging, and it is a location where physical examination is highly specific for assessing the presence and the extent of disease but is associated with low sensitivity. The posterior vaginal fornix is the primary site for vaginal involvement, often arising from the inferior extension of a retrocervical lesion. The vaginal involvement ultrasound (US) diagnostic is very subtle and requires a high level of expertise. On MRI, vaginal involvement is reflected by the presence of a hyposignal T2 nodule under the reflection of the peritoneum behind the uterine cervix.\nAccess this chapter\nTax calculation will be finalised at checkout\nPurchases are for personal use only\nSimilar content being viewed by others\nReferences\nChapron C, Fauconnier A, Vieira M, et al. Anatomical distribution of deeply infiltrating endometriosis: surgical implications and proposition for a classification. Hum Reprod. 2003;18(1):157–61. https://doi.org/10.1093/humrep/deg009.\nBazot M, Darai E, Hourani R, et al. Deep pelvic endometriosis: MR imaging for diagnosis and prediction of extension of disease. Radiology. 2004;232(2):379–89. https://doi.org/10.1148/radiol.2322030762.\nLeonardi M, Singh SS, Murji A, et al. Deep endometriosis: a diagnostic dilemma with significant surgical consequences. 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Gynecol Obstet Fertil Senol. 2020;48(5):457–9. https://doi.org/10.1016/j.gofs.2020.03.004.\nAuthor information\nAuthors and Affiliations\nCorresponding author\nEditor information\nEditors and Affiliations\nRights and permissions\nCopyright information\n© 2025 The Author(s), under exclusive license to Springer Nature Switzerland AG\nAbout this chapter\nCite this chapter\nFlorin, M., Dabi, Y. (2025). Mediocentral Compartment: Vaginal Endometriosis and Rectovaginal Septum. In: Thomassin-Naggara, I. (eds) Imaging of Endometriosis: A Comparative Guide of US, MRI and Surgery. Springer, Cham. https://doi.org/10.1007/978-3-031-82750-1_7\nDownload citation\nDOI: https://doi.org/10.1007/978-3-031-82750-1_7\nPublished:\nPublisher Name: Springer, Cham\nPrint ISBN: 978-3-031-82749-5\nOnline ISBN: 978-3-031-82750-1\neBook Packages: MedicineMedicine (R0)","source_license":"CC0","license_restricted":false}