Beyond laparoscopy: 3-T magnetic resonance imaging in the evaluation of posterior cul-de-sac obliteration

Manganaro L, Lucia Manganaro, Giorgio Vittori, Vittori G, Vinci V, Valeria Vinci, Fierro F, Francesca Fierro, Alessandra Tomei, Tomei A, Lodise P, Pietro Lodise, Paolo Sollazzo, Sollazzo P, Maria Eleonora Sergi, Sergi ME, Maria E Sergi, Bernardo S, Silvia Bernardo, Laura Ballesio, Mario Marini, Marini M, Maria Grazia Porpora, Maria G Porpora
Magnetic resonance imaging · 2012 · vol. 30(10) , pp. 1432–1438 · doi:10.1016/j.mri.2012.05.006 · PMID:22835943 · W1970567341
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This paper explores the utility of 3-T MRI for evaluating posterior cul-de-sac obliteration, comparing its diagnostic capabilities to laparoscopy.

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The provided text consists of metadata and journal information for the publication Magnetic Resonance Imaging rather than the full content of the research article titled "Beyond laparoscopy: 3-T magnetic resonance imaging in the evaluation of posterior cul-de-sac obliteration." Consequently, specific details regarding the study population, methodological approaches, or key findings cannot be extracted from the available input. The abstract and main body of the paper are not included in the source material, preventing a summary of the clinical data or diagnostic accuracy results. The paper does not explicitly discuss endometriosis or adenomyosis; it was included in the corpus via a keyword match in the upstream search index.

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Abstract

ObjectivesEndometriosis is the ectopic localization of endometrial glands. Symptoms include a wide variety of chronic pelvic pain. Ovarian endometriosis represents the most frequent site of implantation followed by the Douglas pouch which is undepicted unless peritoneal fluid is present. Pelvic exams may be reported as normal in 40% of evaluations, although multiple nodularities are located in this region. Nowadays, laparoscopy represents the standard technique for endometriosis evaluation. However, magnetic resonance imaging (MRI) remains the best noninvasive technique for the evaluation of pelvic lesions. According to the importance of a precise preoperative diagnosis of deep infiltrative endometriosis involving the Douglas pouch, we evaluated feasibility of a 3-T system in the evaluation of this particular region.MethodsWe enrolled 19 women coming with either ultrasound or anamnestic suspicion of endometriosis. Pelvic MRI examination was performed on the 3-T system. We applied a standard exam protocol including pulse sequences [single-shot fast spin echo (FSE)] and high-resolution T2W and T1W FSE sequences with and without FS.ResultsMRI diagnosed posterior cul-de-sac obliteration in 15/19 patients. MRI findings were compared with laparoscopy, thus obtaining the following statistical values: mean sensitivity, specificity, positive predictive value and negative predictive value, respectively, of 93%, 75%, 93% and 75%. Moreover, we calculated an interobserver agreement k value of 0.72 with a substantial degree of agreement between two radiologists of a sensitivity value of 93% and specificity value of 75%.ConclusionsPrecise preoperative mapping of posterior cul-de-sac region is essential for a preoperative planning. In our work, the 3-T MRI was shown to be excellent in the evaluation of posterior cul-de-sac obliteration associated to an optimal evaluation of the uterosacral ligaments due to the higher contrast spatial resolution.
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About the journal An International Journal of Basic Research and Clinical Applications Magnetic Resonance Imaging (MRI) is the first international multidisciplinary journal encompassing physical, life, and clinical science investigations as they relate to the development and use of magnetic resonance imaging. MRI is … 5 days Submission to first decision 46 days Submission to decision after review 93 days Submission to acceptance 2 days Acceptance to online publication Editor-in-Chief View full editorial boardArticles Research articleAbstract onlyDecember 2026 https://doi.org/10.1016/j.mri.2026.110764 Research articleAbstract onlyDecember 2026 https://doi.org/10.1016/j.mri.2026.110767 Research articleAbstract onlyDecember 2026 https://doi.org/10.1016/j.mri.2026.110766 Research articleAbstract onlyDecember 2026 https://doi.org/10.1016/j.mri.2026.110762 Special issues and article collections Online ISSN: 1873-5894 Print ISSN: 0730-725X Copyright © 2026 Elsevier Inc. All rights are reserved, including those for text and data mining, AI training, and similar technologies.

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Condition tags

endometriosis

MeSH descriptors

Endometriosis Laparoscopy Magnetic Resonance Imaging Ovary Adult Douglas' Pouch Douglas' Pouch Endometriosis Endometriosis Female Humans Image Processing, Computer-Assisted Image Processing, Computer-Assisted Laparoscopy Magnetic Resonance Imaging Observer Variation Ovary Predictive Value of Tests Radiology Radiology

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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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