{"paper_id":"a6be06d7-7d5d-485d-bf96-012a0f96d02c","body_text":"ECR 2026 / C-26632\nFunctional MRI in Endometriosis: Diffusion, Blood Oxygen Level–Dependent (BOLD), and Intravoxel Incoherent Motion (IVIM)\nCongress:\nECR 2026\nPoster Number:\nC-26632\nType:\nScientific Exhibit\nKeywords:\nGenital / Reproductive system female, Pelvis, MR-Functional imaging, Diagnostic procedure, Imaging sequences, Outcomes, Pathology\nAuthors:\nF. Abubacker Sulaiman, R. Praveenkumar, M. Nivitha, S. Zainamb Begum, J. Lydia, A. Raashid Ibrahim\nDOI:\n10.26044/ecr2026/C-26632\nPurpose\nTo evaluate the role of advanced functional MRI techniques—Diffusion-Weighted Imaging (DWI), Blood Oxygen Level–Dependent (BOLD) imaging, and Intravoxel Incoherent Motion (IVIM)—in assessing endometriotic lesions and to correlate quantitative imaging biomarkers with clinical severity and histopathologic features.Endometriosis is a chronic, estrogen-dependent inflammatory disorder characterized by the presence of functional endometrial glands and stroma outside the uterine cavity. It affects nearly 10% of women of reproductive age and is a significant cause of chronic pelvic pain, dysmenorrhea, dyspareunia, and infertility. Deep infiltrating endometriosis (DIE) represents an aggressive...\nMethods and materials\nA prospective observational study was conducted over 18 months and included 60 women aged 22–42 years who were clinically suspected or surgically confirmed to have endometriosis. Presenting complaints included chronic pelvic pain, severe dysmenorrhea, dyspareunia, infertility, or adnexal masses suggestive of endometrioma on ultrasound.Exclusion criteria included pregnancy, prior pelvic malignancy, recent hormonal therapy (within three months), contraindications to MRI, or incomplete imaging datasets.All patients underwent MRI on a 1.5T system using a standardized pelvic protocol. Imaging included conventional sequences followed by functional sequences.Conventional MRI sequences...\nResults\nAmong the 60 patients included:\nOvarian endometriomas: 28 (46.7%)\nDeep infiltrating endometriosis (DIE): 22 (36.7%)\nSuperficial peritoneal implants: 10 (16.6%)\nThe mean VAS pain score was 6.8 ± 1.9. Mean serum CA-125 level was 48.6 ± 21.3 U/mL.\nDiffusion Findings\nMean ADC values were significantly lower in endometriotic lesions compared to normal myometrium:\nEndometriotic lesions: 0.92 ± 0.14 × 10⁻³ mm²/s\nNormal myometrium: 1.34 ± 0.18 × 10⁻³ mm²/s\np < 0.001\nSubgroup analysis demonstrated:\nDIE: 0.84 ± 0.11 × 10⁻³ mm²/s\nOvarian endometriomas: 0.97...\nConclusion\nFunctional MRI techniques including DWI, IVIM, and BOLD imaging provide comprehensive assessment of tissue diffusion, microvascular perfusion, and oxygenation in endometriosis. Endometriotic lesions demonstrate restricted diffusion, increased perfusion fraction, and elevated R2* values, particularly in deep infiltrating disease.Quantitative imaging biomarkers correlate significantly with clinical severity and serum CA-125 levels. Multiparametric functional MRI significantly enhances diagnostic accuracy compared with conventional MRI.These findings support the integration of advanced functional MRI into routine pelvic imaging protocols for improved disease characterization, severity assessment, and potential therapeutic monitoring\nPersonal information and conflict of interest\nF. Abubacker Sulaiman:\nNothing to disclose\nR. Praveenkumar:\nNothing to disclose\nM. Nivitha:\nNothing to disclose\nS. Zainamb Begum:\nNothing to disclose\nJ. Lydia:\nNothing to disclose\nA. Raashid Ibrahim:\nNothing to disclose\nReferences\nAlonzo L, Cannella R, Gullo G, Piombo G, Cicero G, Lopez A, et al. Magnetic resonance imaging of endometriosis: the role of advanced techniques. J Clin Med. 2024;13(19):5783. doi:10.3390/jcm13195783.\nShams El Dine NM, Dawoud MM, Abd El-mabod NM, Samir El-Deeb B. Functional magnetic resonance imaging in diagnosis of pelvic endometriosis. Int J Radiol Diagn Imaging. 2024;7(1):1–7.\nThomassin-Naggara I, Dolciami M, Chamie LP, Guerra A, Bharwani N, Freeman S, et al. ESUR consensus statement on MRI for endometriosis: indications, standardized reporting and structured imaging protocol. Eur...","source_license":"CC0","license_restricted":false}