Endometriosis: clinical features, MR imaging findings and pathologic correlation

Pietro Valerio Foti, Renato Farina, Stefano Palmucci, Ilenia Vizzini, Ilenia Anna Agata Vizzini, Norma Libertini, Maria Coronella, Saveria Spadola, Rosario Caltabiano, M. Iraci, Marco Iraci, Antonio Basile, Pietro Milone, Antonio Cianci, Giovanni Carlo Ettorre
Insights into imaging · 2018 · vol. 9(2) , pp. 149–172 · doi:10.1007/s13244-017-0591-0 · PMID:29450853 · W2793858881
review OA: gold CC0 ⤵ 153 in-corpus citations
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⚙ AI-generated summary by claude@2026-06, 2026-06-08 ⓘ

This paper illustrates the varied magnetic resonance imaging features of endometriosis, emphasizing MRI's role as the best preoperative staging technique for planning surgical approaches.

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⚙ AI-generated deep summary by claude@2026-06, 2026-06-10 ⓘ

This paper reviews the clinical features and histological correlates of endometriosis and illustrates magnetic resonance imaging (MRI) appearances across the main manifestations (ovarian endometriomas, peritoneal implants, and deep pelvic endometriosis) using examples with an included institutional MR protocol. It reports that MRI lesion appearance varies with the amount and age of hemorrhage and with proportions of endometrial tissue, smooth muscle, and fibrosis, and it emphasizes that MRI is used as a second-line modality after ultrasound for preoperative mapping and staging. A major caveat is that definitive diagnosis requires laparoscopy with histological confirmation, and the review presents imaging and protocol considerations rather than new diagnostic performance estimates. This paper is centrally about endometriosis — it focuses on clinical features and MRI findings with pathologic correlation for staging pelvic endometriotic lesions.

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Abstract

OBJECTIVE: We illustrate the magnetic resonance imaging (MRI) features of endometriosis. BACKGROUND: Endometriosis is a chronic gynaecological condition affecting women of reproductive age and may cause pelvic pain and infertility. It is characterized by the growth of functional ectopic endometrial glands and stroma outside the uterus and includes three different manifestations: ovarian endometriomas, peritoneal implants, deep pelvic endometriosis. The primary locations are in the pelvis; extrapelvic endometriosis may rarely occur. Diagnosis requires a combination of clinical history, invasive and non-invasive techniques. The definitive diagnosis is based on laparoscopy with histological confirmation. Diagnostic imaging is necessary for treatment planning. MRI is as a second-line technique after ultrasound. The MRI appearance of endometriotic lesions is variable and depends on the quantity and age of haemorrhage, the amount of endometrial cells, stroma, smooth muscle proliferation and fibrosis. The purpose of surgery is to achieve complete resection of all endometriotic lesions in the same operation. CONCLUSION: Owing to the possibility to perform a complete assessment of all pelvic compartments at one time, MRI represents the best imaging technique for preoperative staging of endometriosis, in order to choose the more appropriate surgical approach and to plan a multidisciplinary team work. TEACHING POINTS: • Endometriosis includes ovarian endometriomas, peritoneal implants and deep pelvic endometriosis. • MRI is a second-line imaging technique after US. • Deep pelvic endometriosis is associated with chronic pelvic pain and infertility. • Endometriosis is characterized by considerable diagnostic delay. • MRI is the best imaging technique for preoperative staging of endometriosis.

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Condition tags

endometriosischronic_pelvic_paininfertility

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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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