Comparison of magnetic resonance imaging findings with and without intravenous contrast in women with pelvic endometriosis: A cross-sectional study

Mohammadreza Delarami, Narges Afzali, Malihe Hasanzadeh Mofrad
International journal of reproductive biomedicine · 2025 · vol. 23(9) , pp. 759–766 · doi:10.18502/ijrm.v23i9.20163 · PMID:41306467 · W4415765256
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⚙ AI-generated summary by claude@2026-06, 2026-06-08 ⓘ

This study found that pelvic MRI with intravenous contrast improved detection of deep infiltrating endometriosis in the rectosigmoid and posterior uterine walls, while pre-contrast MRI better identified DIE in the uterosacral ligaments and torus uterus.

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⚙ AI-generated deep summary by claude@2026-06, 2026-06-10 · read from full text ⓘ

This cross-sectional study compared magnetic resonance imaging findings in women with pelvic endometriosis when scans were performed with versus without intravenous contrast, aiming to assess how contrast influences observed imaging features. The study reports a direct comparison of MRI findings across the two imaging conditions in this endometriosis population, with the key finding focused on differences (or lack of differences) in MRI features attributable to the use of intravenous contrast. A major limitation is that the design is cross-sectional, which restricts conclusions about temporal changes or diagnostic performance beyond the included imaging comparisons. This paper is centrally about endometriosis — it specifically compares MRI findings with and without intravenous contrast in women with pelvic endometriosis.

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Abstract

Background: Endometriosis is a common disease of the female genital system. Pelvic magnetic resonance imaging (MRI) is the best non-invasive diagnostic method for evaluating endometriosis. Objective: This study aims to compare the findings of MRI with and without intravenous (IV) contrast in participants with endometriosis. Materials and Methods: This cross-sectional study was conducted on 100 women of reproductive age with endometriosis at gynecology clinics of 22 Bahman and Ghaem hospital, Mashhad, Iran from April 2021-July 2023. All participants underwent pelvic MRI with and without IV contrast. The imaging findings of each participant were recorded in the study checklist. Vaginal and rectal gels were applied prior to imaging to improve anatomical delineation. Results: 72% of the participants were aged between 26 and 40 yr. History of infertility was positive in 42% of the individuals. The frequency of ovarian endometrioma detection and its mean size before and after contrast injection did not show a significant difference. The mean depth of rectosigmoid wall and posterior uterine wall endometriosis was significantly higher in images with IV contrast than in images without IV (p = 0.026 and 0.04, respectively). Conversely, the detection of deep infiltrating endometriosis (DIE) in uterosacral ligaments and torus uterus was significantly higher in pre-contrast MRI (p = 0.016). Conclusion: In cases with DIE in the rectal and posterior walls of the uterus, MRI with IV contrast is more accurate in the detection of the disease extent. DIE in the uterosacral ligaments and torus uterus is better detected in MRI without IV contrast.
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Publication International Journal of Reproductive BioMedicine (IJRM) Record type Journal article Published 1 November 2025 Authors Mohammadreza Delarami | Malihe Hasanzadeh Mofrad The publisher of this work supports multiple resolution. The work is available from the following locations: {'doi': '10.18502/ijrm.v23i9.20163', 'member_id': '7770', 'member': 'Knowledge E DMCC', 'container-title': 'International Journal of Reproductive BioMedicine (IJRM)', 'primary-resource': 'https://knepublishing.com/index.php/ijrm/article/view/20163', 'tld': 'knepublishing.com', 'clearbit-logo': '/static/no_logo.svg', 'coaccess': [], 'multiple-resolution': [{'url': 'http://ijrm.ir/article-1-3492-en.html', 'tld': 'ijrm.ir', 'clearbit-logo': '/static/no_logo.svg'}], 'type': 'JOURNAL ARTICLE', 'published_date': '1 November 2025', 'publication': 'International Journal of Reproductive BioMedicine (IJRM)', 'title': 'Comparison of magnetic resonance imaging findings with and without intravenous contrast in women with pelvic endometriosis: A cross-sectional study', 'name': None, 'id': None, 'location': None, 'display_doi': 'https://doi.org/10.18502/ijrm.v23i9.20163', 'grant_info': None, 'grant_info_funders': None, 'grant_info_funder_ids': '', 'grant_info_type': None, 'multiple_lead_investigators': [], 'multiple_co_lead_investigators': [], 'multiple_investigators': [], 'finances': [], 'project_description': None, 'award_amount': None, 'award_start': None, 'funding_scheme': None, 'internal_award_number': None, 'editors': None, 'authors': 'Mohammadreza Delarami | Malihe Hasanzadeh Mofrad', 'chairs': None, 'supplementary_ids': None} https://doi.org/10.18502/ijrm.v23i9.20163 JSON XML

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Condition tags

endometriosisdie_deep_infiltratingendometriomainfertility

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Papers in the corpus that this work cites (lower rings, blue) and that cite this one (upper rings, green). Dot size scales with the paper's in-corpus citation count — bigger dot = more influential within the endo/adeno field. Click a dot to open that paper. [ expand to 2 hops ] — adds papers reached through this work's immediate citers/citees. Heavier; up to 60 extra dots.

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