{"paper_id":"f91c4c5b-727a-4ab4-b4f8-0d79bc58650a","body_text":"Abstract\nObjective\nThe purpose of the pictorial essay is to show the MR imaging (MRI) findings associated with deep pelvic endometriosis.\nConclusion\nMRI is an excellent imaging modality for the evaluation of patients with deep pelvic endometriosis, showing high accuracy in the diagnosis and prediction of disease extent. Its multiplanar capabilities and superior soft tissue contrast are extremely useful in the detection of deeply infiltrating endometriotic implants, even in the setting of intense desmoplastic response that may result in complete obliteration of the posterior cul-de-sac and fixed retroversion of the uterus, which limits the scope of laparoscopy. The use of endovaginal and rectal contrast is helpful to better delineate the anatomy of interest and map out the extent of disease, contributing to more effective treatment planning.\nSimilar content being viewed by others\nReferences\nWoodward PJ, Sohaey R, Mezzetti TP Jr (2001) Endometriosis: radiologic-pathologic correlation. Radiographics 21:193–216 (questionnaire 288-194)\nDel Frate C, Girometti R, Pittino M, et al. (2006) Deep retroperitoneal pelvic endometriosis: MR imaging appearance with laparoscopic correlation. Radiographics 26:1705–1718\nChapron C, Dubuisson JB (2001) Management of deep endometriosis. Ann N Y Acad Sci 943:276–280\nAbbott JA, Hawe J, Clayton RD, Garry R (2003) The effects and effectiveness of laparoscopic excision of endometriosis: a prospective study with 2–5 year follow-up. Hum Reprod 18:1922–1927\nVarol N, Maher P, Healey M, et al. (2003) Rectal surgery for endometriosis—should we be aggressive? J Am Assoc Gynecol Laparosc 10:182–189\nNisolle M, Donnez J (1997) Peritoneal endometriosis, ovarian endometriosis, and adenomyotic nodules of the rectovaginal septum are three different entities. Fertil Steril 68:585–596\nSarma D, Iyengar P, Marotta TR, et al. (2004) Cerebellar endometriosis. AJR Am J Roentgenol 182:1543–1546\nOlive DL, Schwartz LB (1993) Endometriosis. N Engl J Med 328:1759–1769\nAbrao MS, Goncalves MO, Dias JA Jr, et al. (2007) Comparison between clinical examination, transvaginal sonography and magnetic resonance imaging for the diagnosis of deep endometriosis. Hum Reprod 22:3092–3097\nPiketty M, Chopin N, Dousset B, et al. (2009) Preoperative work-up for patients with deeply infiltrating endometriosis: transvaginal ultrasonography must definitely be the first-line imaging examination. Hum Reprod 24:602–607\nKataoka ML, Togashi K, Yamaoka T, et al. (2005) Posterior cul-de-sac obliteration associated with endometriosis: MR imaging evaluation. Radiology 234:815–823\nRobert Y, Launay S, Mestdagh P, et al. (2002) MRI in gynecology. J Gynecol Obstet Biol Reprod (Paris) 31:417–439\nBazot M, Darai E, Hourani R, et al. (2004) Deep pelvic endometriosis: MR imaging for diagnosis and prediction of extension of disease. Radiology 232:379–389\nTakeuchi H, Kuwatsuru R, Kitade M, et al. (2005) A novel technique using magnetic resonance imaging jelly for evaluation of rectovaginal endometriosis. Fertil Steril 83:442–447\nFukaya T, Hoshiai H, Yajima A (1993) Is pelvic endometriosis always associated with chronic pain? A retrospective study of 618 cases diagnosed by laparoscopy. Am J Obstet Gynecol 169:719–722\nChapron C, Fauconnier A, Dubuisson JB, et al. (2003) Deep infiltrating endometriosis: relation between severity of dysmenorrhoea and extent of disease. Hum Reprod 18:760–766\nBazot M, Bornier C, Dubernard G, et al. (2007) Accuracy of magnetic resonance imaging and rectal endoscopic sonography for the prediction of location of deep pelvic endometriosis. Hum Reprod 22:1457–1463\nBazot M, Darai E (2005) Sonography and MR imaging for the assessment of deep pelvic endometriosis. J Minim Invasive Gynecol 12:178–185 (quiz 177, 186)\nPerry R (2005) Endometriosis: a gynaecological and colorectal disease. N Z Med J 118:U1535\nSircus SI, Sant GR, Ucci AA Jr (1988) Bladder detrusor endometriosis mimicking interstitial cystitis. Urology 32:339–342\nFedele L, Bianchi S, Raffaelli R, Portuese A (1997) Pre-operative assessment of bladder endometriosis. Hum Reprod 12:2519–2522\nAuthor information\nAuthors and Affiliations\nCorresponding author\nRights and permissions\nAbout this article\nCite this article\nMarcal, L., Nothaft, M.A., Coelho, F. et al. Deep pelvic endometriosis: MR imaging. Abdom Imaging 35, 708–715 (2010). https://doi.org/10.1007/s00261-010-9611-y\nPublished:\nIssue date:\nDOI: https://doi.org/10.1007/s00261-010-9611-y","source_license":"public-domain-us","license_restricted":false}