MRI directed US for rectosigmoid endometriosis provides added value for preoperative planning

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Preoperative MRI-directed ultrasound provided better visualization of muscularis propria invasion and multifocal lesions in a case of rectosigmoid endometriosis.

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This pictorial essay describes a case of rectosigmoid endometriosis assessed preoperatively with MRI-directed ultrasound to clarify indeterminate depth of bowel wall invasion and identify multifocal lesions. Using MRI-directed ultrasound, the authors report improved visualization of muscularis propria invasion and better depiction of multiple rectosigmoid lesions, which is relevant because bowel endometriosis extent can affect surgical approach (shaving versus resection). The main limitation is that the report is a single-case presentation rather than a systematic study with broader performance metrics. This paper is centrally about endometriosis — specifically the added value of MRI-directed ultrasound for mapping rectosigmoid bowel involvement for preoperative planning.

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Abstract

Endometriosis is a multifocal disease of pelvis affecting mostly reproductive age women. It can involve genital and extra genital organs. The gastrointestinal tract including rectum and sigmoid colon is the most affected extragenital site. Bowel involvement can change the surgery from simple shaving to resection based on depth of invasion and disease distribution. Benefit of ultrasound for bowel endometriosis, especially for rectum and rectosigmoid colon have been reported, however MRI directed ultrasound, particularly for the lesions which demonstrate indeterminate depth of wall invasion and multifocal bowel involvement hasn’t been reported. Here we present a case of rectosigmoid endometriosis evaluated with preoperative MRI directed ultrasound, which provided better visualization of muscularis propria invasion of the bowel and multifocal lesions. Similar content being viewed by others

References

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Acknowledgements

All authors have contributed this pictorial essay in all aspects. Funding The authors declared that this study has received no financial support or funding. Author information Authors and Affiliations Corresponding author Ethics declarations Conflict of ınterest The authors (CC, SW, TB and WV) have no conflict of interest to declare. IRB approval IRB approval was not required by instutional IRB team. Additional information Publisher's Note Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations. Rights and permissions Springer Nature or its licensor (e.g. a society or other partner) holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law. About this article Cite this article Colak, C., Wang, S.S., Burnett, T.L. et al. MRI directed US for rectosigmoid endometriosis provides added value for preoperative planning. J Ultrasound (2025). https://doi.org/10.1007/s40477-025-01028-5 Received: Accepted: Published: Version of record: DOI: https://doi.org/10.1007/s40477-025-01028-5

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