Shining light in a dark landscape: MRI evaluation of unusual localization of endometriosis

Benedetta Gui, Anna Lia Valentini, Valentini Al, Valeria Ninivaggi, Ninivaggi V, Maura Miccò, Zecchi V, Viola Zecchi, Pier Paolo Grimaldi, Grimaldi PP, Francesco Cambi, Cambi F, Guido M, Maurizio Guido, Bonomo L, Lorenzo Bonomo
Diagnostic and interventional radiology (Ankara, Turkey) · 2017 · vol. 23(4) , pp. 272–281 · doi:10.5152/dir.2017.16364 · PMID:28703103 · PMC5508950 · W2733848657
article OA: green CC0 ⤵ 30 in-corpus citations
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⚙ AI-generated summary by gemini-2.5-flash-lite, 2026-06-08 ⓘ

This paper reviews magnetic resonance imaging findings for unusual pelvic and extrapelvic endometriosis locations, highlighting how the technique distinguishes endometriotic tissue from surrounding fibrosis.

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⚙ AI-generated deep summary by claude@2026-07, 2026-07-12 · read from full text ⓘ

The paper discusses how MRI can evaluate atypical, unusual localizations of endometriosis beyond the most common sites, describing pelvic examples (e.g., cervix, vagina, round ligaments, ureter, nerves) and rare extrapelvic implants (e.g., upper abdomen, subphrenic fold, abdominal wall). It outlines high-level rationale for MRI as a problem-solving tool, emphasizing multiplanar imaging, high contrast resolution, and lack of ionizing radiation, and explains that endometriotic tissue with hemorrhagic content can be distinguished from adhesions and fibrosis. A stated limitation is that the work is primarily a reminder and illustration of MRI findings rather than a comparative or population-based diagnostic study. This paper is centrally about endometriosis — it focuses on MRI evaluation of atypical pelvic and extrapelvic endometriosis localizations and characteristic imaging features.

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Abstract

Endometriosis is a disease distinguished by the presence of endometrial tissue outside the uterine cavity with intralesional recurrent bleeding and resulting fibrosis. The most common locations for endometriosis are the ovaries, pelvic peritoneum, uterosacral ligaments, and torus uterinus. Typical symptoms are secondary dysmenorrhea and cyclic or chronic pelvic pain. Unusual sites of endometriosis may be associated with specific symptoms depending on the localization. Atypical pelvic endometriosis localizations can occur in the cervix, vagina, round ligaments, ureter, and nerves. Moreover, rare extrapelvic endometriosis implants can be localized in the upper abdomen, subphrenic fold, or in the abdominal wall. Magnetic resonance imaging (MRI) represents a problem-solving tool among other imaging modalities. MRI is an advantageous technique, because of its multiplanarity, high contrast resolution, and lack of ionizing radiation. Our purpose is to remind the radiologists the possibility of atypical pelvic and extrapelvic endometriosis localizations and to illustrate the specific MRI findings. Endometriotic tissue with hemorrhagic content can be distinguished from adherences and fibrosis on MRI imaging. Radiologists should keep in mind these atypical localizations in patients with suspected endometriosis, in order to achieve the diagnosis and to help the clinicians in planning a correct and complete treatment strategy.
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ABSTRACT Endometriosis is a disease distinguished by the presence of endometrial tissue outside the uterine cavity with intralesional recurrent bleeding and resulting fibrosis. The most common locations for endometriosis are the ovaries, pelvic peritoneum, uterosacral ligaments, and torus uterinus. Typical symptoms are secondary dysmenorrhea and cyclic or chronic pelvic pain. Unusual sites of endometriosis may be associated with specific symptoms depending on the localization. Atypical pelvic endometriosis localizations can occur in the cervix, vagina, round ligaments, ureter, and nerves. Moreover, rare extrapelvic endometriosis implants can be localized in the upper abdomen, subphrenic fold, or in the abdominal wall. Magnetic resonance imaging (MRI) represents a problem-solving tool among other imaging modalities. MRI is an advantageous technique, because of its multiplanarity, high contrast resolution, and lack of ionizing radiation. Our purpose is to remind the radiologists the possibility of atypical pelvic and extrapelvic endometriosis localizations and to illustrate the specific MRI findings. Endometriotic tissue with hemorrhagic content can be distinguished from adherences and fibrosis on MRI imaging. Radiologists should keep in mind these atypical localizations in patients with suspected endometriosis, in order to achieve the diagnosis and to help the clinicians in planning a correct and complete treatment strategy.

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Condition tags

endometriosischronic_pelvic_paindysmenorrhea

MeSH descriptors

Endometriosis Magnetic Resonance Imaging Endometriosis Female Humans Magnetic Resonance Imaging Pelvis Pelvis

Citation neighborhood

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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