Deep infiltrating endometriosis: role of magnetic resonance subtraction imaging

Darshan Gandhi, Gunjan Garg, Shantanu Solanki, Pankaj Nepal
Quantitative imaging in medicine and surgery · 2018 · vol. 8(7) , pp. 722–723 · doi:10.21037/qims.2018.08.06 · PMID:30211039 · PMC6127518 · W2888090797
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⚙ AI-generated summary by claude@2026-06, 2026-06-09 ⓘ

This paper presents a pictorial review of deep infiltrating endometriosis using magnetic resonance imaging and correlates the imaging findings with surgical outcomes.

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⚙ AI-generated deep summary by claude@2026-06, 2026-06-14 · read from full text ⓘ

This paper is a letter/commentary that discusses deep infiltrating endometriosis (DIE) and emphasizes the role of magnetic resonance subtraction imaging in diagnosing small deep pelvic endometriotic implants, especially when conventional T1 hyperintensity from hemorrhagic or proteinaceous fluid makes contrast assessment difficult. It describes how subtraction imaging is generated from fat-saturated T1 pre- and post-gadolinium sequences acquired with identical criteria, so remaining signal reflects enhancement, helping to isolate enhancing foci of endometriosis adjacent to T1-hyperintense fluid. The authors illustrate a case where pelvic MRI with subtraction sequences identified deep pelvic endometriotic implants, and they note subtraction imaging can clarify differentiation among complex T1 hyperintense cystic lesions such as ectopic pregnancy. This paper is centrally about endometriosis — it focuses on DIE MRI and argues for the diagnostic utility of MR subtraction imaging in small deep pelvic implants and related unusual endometriosis presentations, including contexts involving an adenomyotic uterus.

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Abstract

We read the manuscript titled “ Deep infiltrating endometriosis MR imaging with surgical correlation ” by Tang et al . with educational interest (1). We would like to congratulate the authors for presenting valuable pictorial review of deep infiltrating endometriosis (DIE) with meticulous description of magnetic resonance imaging (MRI) findings of endometriosis.
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Acknowledgements

None. Footnote Conflicts of Interest: The authors have no conflicts of interest to declare.

References

- Tang X, Ling R, Gong J, Mei D, Luo Y, Li M, Xu J, Ma L. Deep infiltrating endometriosis MR imaging with surgical correlation. Quant Imaging Med Surg 2018;8:187-95. [Crossref] [PubMed] - Siegelman ES, Oliver ER. MR imaging of endometriosis: ten imaging pearls. Radiographics 2012;32:1675-91. [Crossref] [PubMed] - Newatia A, Khatri G, Friedman B, Hines J. Subtraction imaging: applications for nonvascular abdominal MRI. AJR Am J Roentgenol 2007;188:1018-25. [Crossref] [PubMed] - Eid M, Abougabal A. Subtraction images: A really helpful tool in non-vascular MRI. The Egyptian Journal of Radiology and Nuclear Medicine 2014;45:909-19. [Crossref] - Chanana C, Gupta N, Bansal I, Hooda K, Sharma P, Gupta M, Gandhi D, Kumar Y. Different Sonographic Faces of Ectopic Pregnancy. J Clin Imaging Sci 2017;7:6. [Crossref] [PubMed] - Bennett GL, Slywotzky CM, Cantera M, Hecht EM. Unusual manifestations and complications of endometriosis--spectrum of imaging findings: pictorial review. AJR Am J Roentgenol 2010;194:WS34-46. [Crossref] [PubMed]

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endometriosisdie_deep_infiltrating

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