Mediocentral Compartment: Torus Uterinum and Proximal Uterosacral Ligaments

In: Imaging of Endometriosis: A Comparative Guide of US, MRI and Surgery · 2025 · pp. 107–122 · doi:10.1007/978-3-031-82750-1_6 · W4410897507
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This review examines the anatomy of uterosacral ligaments and torus uterinum for diagnosing deep pelvic endometriosis via imaging, considering classification systems, diagnostic pitfalls, and surgical implications.

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This paper is a comprehensive review of the anatomy and diagnostic significance of the uterosacral ligaments—specifically the mediocentral compartment features including the torus uterinum and proximal USLs—in deep pelvic endometriosis, focusing on evaluation with transvaginal ultrasound (TVUS) and MRI. It synthesizes classification systems and diagnostic criteria, describes common morphological appearances and lesion extensions/associated adhesions, and highlights pitfalls and technical challenges in interpreting imaging findings, along with surgical implications for laparoscopic exploration. The authors note that accurate preoperative imaging is important, but interpretation may be complicated by diagnostic pitfalls and imaging limitations. This paper is centrally about endometriosis — it reviews how torus uterinum and proximal uterosacral ligaments are evaluated by US and MRI for diagnosing deep pelvic endometriosis.

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Abstract

This comprehensive review addresses the intricate anatomy of uterosacral ligaments (USLs) and their significance in diagnosing deep pelvic endometriosis (DPE), namely via transvaginal ultrasound (TVUS) and magnetic resonance imaging (MRI). Various classification systems and diagnostic criteria are explored, alongside pitfalls in interpretation and potential technical challenges. Surgical implications, particularly concerning laparoscopic exploration, are highlighted, emphasizing the importance of accurate preoperative imaging. Insights into the morphological appearance of DPE lesions, their extensions, and associated adhesions are provided. Overall, this review underscores the critical role of USL and torus uterinum evaluation in DPE diagnosis and management. Access this chapter Tax calculation will be finalised at checkout Purchases are for personal use only Similar content being viewed by others

References

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Endometriosis MR mimickers: T2-hypointense lesions. Insights Imaging. 2024;15:20. Author information Authors and Affiliations Editor information Editors and Affiliations Rights and permissions Copyright information © 2025 The Author(s), under exclusive license to Springer Nature Switzerland AG About this chapter Cite this chapter Guerra, A., Janicas, C., Manso, M., Fortuna, I. (2025). Mediocentral Compartment: Torus Uterinum and Proximal Uterosacral Ligaments. In: Thomassin-Naggara, I. (eds) Imaging of Endometriosis: A Comparative Guide of US, MRI and Surgery. Springer, Cham. https://doi.org/10.1007/978-3-031-82750-1_6 Download citation DOI: https://doi.org/10.1007/978-3-031-82750-1_6 Published: Publisher Name: Springer, Cham Print ISBN: 978-3-031-82749-5 Online ISBN: 978-3-031-82750-1 eBook Packages: MedicineMedicine (R0)

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