MRI Features of Pelvic Nerve Involvement in Endometriosis

Ceylan Çolak, Luciana Pardini Chamié, Jonathan Youngner, Michael C Forney, Miguel Luna Russo, Miguel A Luna Russo, Ashley Gubbels, Wendaline M. VanBuren, Myra Feldman
Radiographics : a review publication of the Radiological Society of North America, Inc · 2024 · vol. 44(1) , pp. e230106 · doi:10.1148/rg.230106 · PMID:38170677 · W4390535152
article OA: closed CC0 ⤵ 14 in-corpus citations
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⚙ AI-generated summary by claude@2026-06, 2026-06-07 ⓘ

This study identified pelvic MRI features for evaluating nerve involvement in endometriosis, detailing commonly affected nerves and associated imaging techniques to aid diagnosis and treatment planning.

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Abstract

Endometriosis is a common condition that mostly affects people assigned as female at birth. The most common clinical symptom of endometriosis is pain. Although the mechanism for this pain is poorly understood, in some cases, the nerves are directly involved in endometriosis. Endometriosis is a multifocal disease, and the pelvis is the most common location involved. Nerves in the pelvis can become entrapped and involved in endometriosis. Pelvic nerves are visible at pelvic MRI, especially when imaging planes and sequences are tailored for neural evaluation. In particular, high-spatial-resolution anatomic imaging including three-dimensional isotropic imaging and contrast-enhanced three-dimensional short inversion time inversion-recovery (STIR) fast spin-echo sequences are useful for nerve imaging. The most commonly involved nerves are the sciatic, obturator, femoral, pudendal, and inferior hypogastric nerves and the inferior hypogastric and lumbosacral plexuses. Although it is thought to be rare, the true incidence of nerve involvement in endometriosis is not known. Symptoms of neural involvement include pain, weakness, numbness, incontinence, and paraplegia and may be constant or cyclic (catamenial). Early diagnosis of neural involvement in endometriosis is important to prevent irreversible nerve damage and chronic sensorimotor neuropathy. Evidence of irreversible damage can also be seen at MRI, and radiologists should evaluate pelvic nerves that are commonly involved in endometriosis in their search pattern and report template to ensure that this information is incorporated into treatment planning.

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Condition tags

mesh:D004715endometriosis

MeSH descriptors

Endometriosis Endometriosis Endometriosis Endometriosis Endometriosis Endometriosis Peripheral Nervous System Diseases Peripheral Nervous System Diseases Peripheral Nervous System Diseases Peripheral Nervous System Diseases Peripheral Nervous System Diseases Peripheral Nervous System Diseases Female Female Female Female Female Humans Humans Humans

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.

References (64)

Cited by (14)

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License: CC0 · commercial use OK