{"paper_id":"4de82f70-a709-4de3-a1ca-321ddcad285d","body_text":"Abstract\nThis chapter aims at illustrating the diagnostic tools currently used for the diagnosis of endometriosis.\nA paragraph will focus on epidemiology and theories proposed to explain the genesis of pain.\nWe will discuss the role of Magnetic Resonance Imaging, as the second level imaging modality. MRI application in endometriosis will follow the section regarding TVUS; we will discuss protocol and MRI features of endometriosis.\nWe will go through the three main forms of endometriosis, endometrioma, peritoneal endometriosis, and deep infiltrating implants, showing their appearance in the two imaging modalities.\nAt last a brief paragraph will show MRI techniques recently applied to directly evaluate the neural involvement in case of severe endometriosis related pain.\nAccess this chapter\nTax calculation will be finalised at checkout\nPurchases are for personal use only\nSimilar content being viewed by others\nReferences\nKobayashi H, Higashiura Y, Shigetomi H, Kajihara H. Pathogenesis of endometriosis: the role of initial infection and subsequent sterile inflammation (Review). Mol Med Rep. 2014;9(1):9–15.\nGiudice LC, Kao LC. Endometriosis. Lancet. 2004;364(9447):1789–99.\nNnoaham KE, Hummelshoj L, Webster P, d’Hooghe T, de Cicco Nardone F, de Cicco Nardone C, et al. Impact of endometriosis on quality of life and work productivity: a multicenter study across ten countries. Fertil Steril. 2011;96(2):366–73.\nBallard KD, Seaman HE, de Vries CS, Wright JT. Can symptomatology help in the diagnosis of endometriosis? Findings from a national case-control study - Part 1. BJOG. 2008;115(11):1382:91.\nApostolopoulos NV, Alexandraki KI, Gorry A, Coker A. Association between chronic pelvic pain symptoms and the presence of endometriosis. Arch Gynecol Obstet. 2016;293(2):439–45.\nKoninckx PR, Meuleman C, Demeyere S, Lesaffre E, Cornillie FJ. Suggestive evidence that pelvic endometriosis is a progressive disease, whereas deeply infiltrating endometriosis is associated with pelvic pain. Fertil Steril. 1991;55(4):759–65.\nPorpora MG, Koninckx PR, Piazze J, Natili M, Colagrande S, Cosmi EV. Correlation between endometriosis and pelvic pain. J Am Assoc Gynecol Laparosc. 1999;6(4):429–34.\nFauconnier A, Chapron C. Endometriosis and pelvic pain: epidemiological evidence of the relationship and implications. Hum Reprod Update. 2005;11(6):595–606.\nKobayashi H, Yamada Y, Morioka S, Niiro E, Shigemitsu A, Ito F. Mechanism of pain generation for endometriosis-associated pelvic pain. Archiv Gynecol Obstet. 2014;289(1):13–21.\nBerkley KJ, Dmitrieva N, Curtis KS, Papka ER. Innervation of ectopic endometrium in a rat model of endometriosis. Proc Natl Acad Sci USA. 2004;101(30):11094–8.\nBerkley KJ, Rapkin AJ, Papka RE. The pains of endometriosis. Science. 2005;308(5728):1587–9.\nWang G, Tokushige N, Markham R, Fraser IS, et al. Rich innervation of deep infiltrating endometriosis. Hum Reprod. 2009;24(4):827–34.\nMcKinnon BD, Bertschi D, Bersinger NA, Mueller MD. Inflammation and nerve fiber interaction in endometriotic pain. Trends Endocrinol Metab. 2015;26(1):1–10.\nAnaf V, Simon P, El Nakadi I, Fayt I, Buxant F, Simonart T, et al. Relationship between endometriotic foci and nerves in rectovaginal endometriotic nodules. Hum Reprod (Oxford, England). 2000;15(8):1744–50.\nAnaf V, Simon P, El Nakadi I, Fayt I, Buxant F, Noel JC. Hyperalgesia, nerve infiltration and nerve growth factor expression in deep adenomyotic nodules, peritoneal and ovarian endometriosis. Hum Reprod. 2002;17(7):1895–900.\nStratton P, Berkley KJ. Chronic pelvic pain and endometriosis: translational evidence of the relationship and implications. Hum Reprod Update. 2011;17(3):327–46.\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.\nVan Holsbeke C, Van Calster B, Guerriero S, Savelli L, Paladini D, Lissoni AA, et al. Endometriomas: Their ultrasound characteristics. Ultrasound Obstet Gynecol. 2010;35:735–40.\nMoore J, Copley S, Morris J, Lindsell D, Golding S, Kennedy S. A systematic review of the accuracy of ultrasound in the diagnosis of endometriosis. Ultrasound Obstet Gynecol. 2002;20(6):630–4.\nExacoustos C, Manganaro L, Zupi E. Imaging for the evaluation of endometriosis and adenomyosis. Best Pract Res Clin Obstet Gynaecol. 2014;28(5):655–81.\nChapron C, et al. Anatomical distribution of deeply infiltrating endometriosis: Surgical implications and proposition for a classification. Hum Reprod. 2003;18(1):157–61.\nFedele L, Bianchi S, Raffaelli R, Portuese A. Pre-operative assessment of bladder endometriosis. Hum Reprod. 1997;12(11):2519–22.\nHudelist G, English J, Thomas AE, Tinelli A, Singer CF, Keckstein J. Diagnostic accuracy of transvaginal ultrasound for non-invasive diagnosis of bowel endometriosis: Systematic review and meta-analysis. Ultrasound Obstet Gynecol. 2011;37(3):257–63.\nChamié LP, Pereira Alves Mendes R, Zanatta A, Serafini PS. Transvaginal US after bowel preparation for deeply infiltrating endometriosis: protocol, imaging appearances, and laparoscopic correlation. Radiographics. 2010;30:1235–49.\nChamié LP, Blasbalg R, Goncalves MO, Carvalho FM, Abrao MS, de Oliveira IS. Accuracy of magnetic resonance imaging for diagnosis and preoperative assessment of deeply infiltrating endometriosis. Int J Gynaecol Obstet. 2009;196(3):198–201.\nHottat N, Larrousse C, Anaf V, Neol JC, Absil J, Metens T. Endometriosis: contribution of 3.0-T Pelvic MR imaging in preoperative assessment—initial results. Radiology. 2009;253(1):126–34.\nMcDermott S, Oei TN, Iyer RV, Lee SI. MR imaging of malignancies arising in endometriomas and extraovarian endometriosis. Radiographics. 2012;32:845–63.\nCorwin MT, Gerscovich EO, Lamba R, Wilson M, McGahan JP. Differentiation of ovarian endometriomas from hemorrhagic cysts at MR imaging: utility of the T2 Dark spot sign. Radiology. 2014;271(1):126–32.\nSiegelman ES, Oliver ER. MR imaging of endometriosis: ten imaging pearls. Radiographics. 2012;32:1675–91.\nKim MY, Rha SE, Oh SN, Jung SE, Lee Y, Kim YS, et al. MR imaging findings of hydrosalpinx: a comprehensive review. Radiographics. 2009;29:495–507.\nKaproth-Joslin K, Dogra V. Imaging of female infertility: a pictorial guide to the hysterosalpingography, ultrasonography, and magnetic resonance imaging findings of the congenital and acquired causes of female infertility. Radiol Clin North Am. 2013;51(6):967–81.\nKhan KN, Kitajima M, Fujishita A, Hiraki K, Matsumoto A, Nakashima M, et al. Pelvic pain in women with ovarian endometrioma is mostly associated with coexisting peritoneal lesions. Hum Reprod. 2013;28(1):109–18.\nRedwine DB. Ovarian endometriosis: A marker for more extensive pelvic and intestinal disease. Fertil Steril. 1999;72(2):310–5.\nKataoka ML, Togashi K, Yamaoka T, Koyama T, Ueda H, Kobayashi H, et al. Posterior Cul-de-Sac obliteration associated with endometriosis: MR imaging evaluation. Radiology. 2005;234(3):815–23.\nScardapane A, Lorusso F, Scioscia M, Ferrante A, Stabile Ianora AA, Angelelli G. Standard high-resolution pelvic MRI vs. low-resolution pelvic MRI in the evaluation of deep infiltrating endometriosis. Eur Radiol. 2014;24(10):2590–6.\nLo Monte G, Wenger JM, Petignat P, Marci R. Role of imaging in endometriosis. Cleve Clin J Med. 2014;81(6):361–6.\nKrüger K, Gilly L, Kreuter-Niedobitek G, Mpinou L, Ebert AD. Bladder endometriosis: characterization by magnetic resonance imaging and the value of documenting ureteral involvement. Eur J Obstet Gynecol Reprod Biol. 2014;176(1):39–43.\nMedeiros LR, Rosa MI, Silva BR, Reis ME, Simon CS, Dondossola ER, et al. Accuracy of magnetic resonance in deeply infiltrating endometriosis: a systematic review and meta-analysis. Arch Gynecol Obstet. 2015;291(3):611–21.\nWolthuis A, Meuleman C, Tomassetti C, D’Hooghe T, Overstraeten Adb M. Bowel endometriosis: Colorectal surgeon’s perspective in a multidisciplinary surgical team. World J Gastroenterol. 2014;20(42):15616–23.\nRousset P, Peyron N, Charlot M, Chateau F, Glfier F, Raudrant D, et al. Bowel endometriosis: preoperative diagnostic accuracy of 3.0-T MR enterography-initial results. Radiology. 2014;273(1):117–24.\nLoubeyre P, Copercini M, Frossard JL, Wenger JM, Petignat P. Pictorial review: rectosigmoid endometriosis on MRI with gel opacification after rectosigmoid colon cleansing. Clin Imaging. 2012;36(4):295–300.\nBazot M, Darai E, Hourani R, Thomassin I, Cortez A, Uzam S, et al. Deep Pelvic Endometriosis: MR imaging for diagnosis and prediction of extension of disease. Radiology. 2004;232(2):379–89.\nPiketty M, Chopin N, Dousset B, Millischer-Bellaische AE, Roseau G, Leconte M, et al. Preoperative work-up for patients with deeply infiltrating endometriosis: Transvaginal ultrasonography must definitely be the first-line imaging examination. Hum Reprod. 2009;24(3):602–7.\nScardapane A, Bettocchi S, Lorusso F, Stabile Ianora AA, Vimercati A, Ceci O, et al. Diagnosis of colorectal endometriosis: contribution of contrast enhanced MR-colonography. Eur Radiol. 2011;21(7):1553–63.\nLakhi N, Dun EC, Nezhat CH. Hematoureter due to endometriosis. Fertil Steril. 2014;101(6):37.\nMissmer SA, Bove GM. A pilot study of the prevalence of leg pain among women with endometriosis. J Bodyw Mov Ther. 2011;15(3):304–8.\nPossover M, Schneider T, Henle KP. Laparoscopic therapy for endometriosis and vascular entrapment of sacral plexus. Fertil Steril. 2011;95(2):756–8.\nHiltunen J, Suortti T, Arvela S, Seppa M, Joensuu R, Hari R. Diffusion tensor imaging and tractography of distal peripheral nerves at 3 T. Clin Neurophysiol. 2005;116(10):2315–23.\nKhalil C, Hancart C, Le Thuc V, Chantelot C, Chechin D, Cotton A. Diffusion tensor imaging and tractography of the median nerve in carpal tunnel syndrome: preliminary results. Eur Radiol. 2008;18(10):2283–91.\nManganaro L, Porpora MG, Vinci V, Bernardo S, Lodise P, Sollazzo P, et al. Diffusion tensor imaging and tractography to evaluate sacral nerve root abnormalities in endometriosis-related pain: A pilot study. Eur Radiol. 2014;24(1):95–101.\nManganaro L, Vittori G, Vinci V, Fierro F, Tomei A, Lodise P, et al. Beyond laparoscopy: 3-T magnetic resonance imaging in the evaluation of posterior cul-de-sac obliteration. Magn Reson Imaging. 2012;30(10):1432–8.\nCottier JP, Descamps P, Sonier CB, Rosset P. Sciatic endometriosis: MR evaluation. AJNR Am J Neuroradiol. 1995;16(7):1399–401.\nPham M, Sommer C, Wessing C, Monoranu CM, Perez SG, Bendszus M. Magnetic resonance neurography for the diagnosis of extrapelvic sciatic endometriosis. Fertil Steril. 2010;94(1):351.e11–4.\nCimsit C, Yoldemir T, Akpinar IN. Sciatic neuroendometriosis: magnetic resonance imaging defined perineural spread of endometriosis. J Obstet Gynaecol Res. 2016;42(7):890–4.\nAuthor information\nAuthors and Affiliations\nCorresponding author\nEditor information\nEditors and Affiliations\n23.1 Electronic Supplementary Material\nEndometrioma of the right ovary (MOV 39347 kb)\nEndometrioma of the right ovary (MOV 6363 kb)\nEndometrioma of the left ovary with typical “shading sign” (MOV 6678 kb)\nEndometrioma of the left ovary with typical “shading sign” (MOV 13607 kb)\nTubal and ovarian endometriosis with hematosalpinx (MOV 6621 kb)\nTubal and ovarian endometriosis with hematosalpinx (MOV 19071 kb)\nTubal and ovarian endometriosis with hematosalpinx (MOV 7124 kb)\nDeep infiltrating endometriosis of posterior compartment with rectal wall infiltration, adenomyosis and ovarian endometriosis (MOV 9905 kb)\nDeep infiltrating endometriosis of posterior compartment with rectal wall infiltration, adenomyosis and ovarian endometriosis (MOV 14576 kb)\nDeep infiltrating endometriosis of posterior compartment with rectal wall infiltration, adenomyosis and ovarian endometriosis (MOV 6344 kb)\nEndometriosis of posterior compartment extended to rectum, parametrium and pelvic wall (MOV 10422 kb)\nEndometriosis of posterior compartment extended to rectum, parametrium and pelvic wall (MOV 5589 kb)\nEndometriosis of posterior compartment (MOV 13980 kb)\nEndometriosis of posterior compartment (with and without gel vaginal and rectal filling) (MOV 11327 kb)\nEndometriosis of posterior compartment (with and without gel vaginal and rectal filling) (MOV 8772 kb)\nEndometriosis of posterior compartment (with and without gel vaginal and rectal filling) (MOV 20512 kb)\nDeep infiltrating endometriosis of anterior compartment (nodule in the vesicouterine pouch (MOV 7964 kb)\nDeep infiltrating endometriosis of posterior and lateral compartments with associated ureteronephrosis; left ovarian endometriosis (MOV 19500 kb)\nDeep infiltrating endometriosis of posterior and lateral compartments with associated ureteronephrosis; left ovarian endometriosis (MOV 7342 kb)\nDeep infiltrating endometriosis of posterior and lateral compartments with associated ureteronephrosis; left ovarian endometriosis (MOV 6505 kb)\nMultifocal deep infiltrating endometriosis with bilateral endometriomas, hematosalpinx and left ureteronephrosis (MOV 9901 kb)\nMultifocal deep infiltrating endometriosis with bilateral endometriomas, hematosalpinx and left ureteronephrosis (MOV 6972 kb)\nAdenomyosis, right tubo-ovarian endometriosis, endometriosis of posterior compartment and of peritoneum (MOV 12520 kb)\nAdenomyosis, right tubo-ovarian endometriosis, endometriosis of posterior compartment and of peritoneum (MOV 13240 kb)\nAdenomyosis, right tubo-ovarian endometriosis, endometriosis of posterior compartment and of peritoneum (MOV 6265 kb)\nAdenomyosis, left hematosalpinx, ovarian and peritoneal endometriosis (MOV 15249 kb)\nAdenomyosis, left hematosalpinx, ovarian and peritoneal endometriosis (MOV 7074 kb)\nAdenomyosis, left hematosalpinx, ovarian and peritoneal endometriosis (MOV 5011 kb)\nAdenomyoma (MOV 6222 kb)\nAdenomyoma (MOV 11131 kb)\nEndometriosis of posterior compartment with infiltration of right puborectalis muscle and ipsilateral sacral nerval roots (MOV 13366 kb)\nEndometriosis of posterior compartment with infiltration of right puborectalis muscle and ipsilateral sacral nerval roots (MOV 6881 kb)\nRights and permissions\nCopyright information\n© 2019 Springer Nature Switzerland AG\nAbout this chapter\nCite this chapter\nManganaro, L., Vinci, V., Capozza, F., Antonelli, A., Satta, S. (2019). Imaging of Endometriosis-Related Pain. In: Cova, M., Stacul, F. (eds) Pain Imaging. Springer, Cham. https://doi.org/10.1007/978-3-319-99822-0_23\nDownload citation\nDOI: https://doi.org/10.1007/978-3-319-99822-0_23\nPublished:\nPublisher Name: Springer, Cham\nPrint ISBN: 978-3-319-99821-3\nOnline ISBN: 978-3-319-99822-0\neBook Packages: MedicineMedicine (R0)\nKeywords\n- Endometriosis\n- Pelvic pain\n- Endometrioma\n- Adenomyosis\n- Adenomyoma\n- Adhesions\n- Fibro endometriosis\n- Deep endometriosis\n- Infiltrating endometriosis\n- Hematosalpinx\n- Peritoneal endometriosis\n- Vaginal endometriosis\n- Bowel endometriosis\n- Bladder endometriosis\n- Pelvic tractography\n- Endometriotic nodule\n- Pouch of Douglas endometriosis\n- Imaging\n- MRI\n- Trans vaginal US","source_license":"CC0","license_restricted":false}