Correlation between MR imaging and operative findings in deep infiltrating endometriosis: lessons learned

Colon, Genital / Reproductive system female, Urinary Tract / Bladder, MR, Intraoperative, Surgery, Education and training, Obstruction / Occlusion, Outcomes Authors: A. Fernandes, P. K. Verasingam DOI: 10.26044/ecr2026/C-20978 Learning objectives Learning objectivesTo evaluate the effectiveness and limitations of preoperative MRI in the diagnosis and surgical planning of deep infiltrating endometriosis (DIE) in the pelvis.

Endometriosis is a common chronic gynaecological condition defined as the presence of functional endometrial tissue (glands and stroma) outside the uterus. There are three morphologic subtypes: Superficial endometriosis implants, Deep infiltrating endometriosis and Endometriomas. In this poster, we aim to discuss the key role of MRI in the diagnosis and surgical planning of DIE with particular attention to the posterior and anterior compartments of the pelvis.This is best achieved by monthly multidisciplinary team (MDT) meetings between the radiologists and the gynaecologists/ endopelvic surgeons with input... Findings and procedure details Posterior compartment: there were 33 intraoperative lesions, of which 27 were correctly diagnosed (81.8%).The 27 diagnosed lesions were: 2 patients with large infiltrative nodules at the rectum causing severe stricture: segmental resection appropriately advised [Fig 1] [Fig 2] [Fig 11]. 5 patients with dense adhesions between the torus uterinus/ posterior wall of uterus and anterior wall of rectum: disc resection advised but bowel shaving performed [Fig 3] [Fig 12]. 20 patients with thin adhesions between uterus and rectum: bowel shaving appropriately advised [Fig 15] [Fig...

Preoperative MRI is highly effective in detecting and accurately describing DIE involving the posterior compartment and in advising the optimal surgical approach. This is very important because viewing of the rectouterine space can be limited during laparoscopy due to adhesions and obliteration.Segmental resection for rectal strictures and bowel shaving for thin adhesions was correctly advised by the radiologist in all cases. However, the correct surgical treatment in cases with dense adhesions may be better decided on the operating table by the endopelvic and colorectal surgeons.Preoperative... Personal information and conflict of interest A. Fernandes: Nothing to disclose P. K. Verasingam: Nothing to disclose

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