Endometriosis MRI lexicon: consensus statement from the society of abdominal radiology endometriosis disease-focused panel

Priyanka Jha, Michelle Sakala, Michelle D. Sakala, Luciana Pardini Chamié, Luciana Pardini Chamie, Myra Feldman, Nicole Hindman, Chenchan Huang, Aoife Kilcoyne, Sherelle Laifer-Narin, Sherelle Laifer‐Narin, Refky Nicola, Liina Poder, Liina Pōder, Anuradha S. Shenoy‐Bhangle, Anuradha Shenoy-Bhangle, Angela Tong, Wendy VanBuren, W. VanBuren, Myles T Taffel
Abdominal radiology (New York) · 2019 · vol. 45(6) , pp. 1552–1568 · doi:10.1007/s00261-019-02291-x · PMID:31728612 · W2986813163
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The Society of Abdominal Radiology’s Endometriosis Disease-Focused Panel presents this consensus document to establish a standardized MRI lexicon for endometriosis evaluation and anatomic localization.

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This consensus statement from the Society of Abdominal Radiology Endometriosis Disease-Focused Panel addresses the heterogeneity in how the literature describes MRI findings and anatomic sites of involvement in endometriosis. It proposes an MRI lexicon and anatomic localization framework intended to standardize endometriosis MRI evaluation and reporting. The main limitation is that the document is a consensus/lexicon rather than a population-based diagnostic accuracy study, so it does not by itself provide quantified performance estimates. This paper is centrally about endometriosis — it provides a standardized MRI lexicon and anatomic localization consensus for evaluating the disease.

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Abstract

Endometriosis is a common gynecologic disorder characterized by the presence of ectopic endometrial tissue outside the endometrial cavity. Magnetic Resonance Imaging (MRI) has become a mainstay for diagnosis and staging of this disease. In the literature, significant heterogeneity exists in the descriptions of imaging findings and anatomic sites of involvement. The Society of Abdominal Radiology’s Endometriosis Disease-Focused Panel presents this consensus document to establish an MRI lexicon for endometriosis MRI evaluation and anatomic localization. Similar content being viewed by others

References

Chamie, L.P., et al., Findings of pelvic endometriosis at transvaginal US, MR imaging, and laparoscopy. Radiographics, 2011. 31(4): p. E77-100. Coutinho, A., Jr., et al., MR imaging in deep pelvic endometriosis: a pictorial essay. Radiographics, 2011. 31(2): p. 549-67. Thalluri, A.L., S. Knox, and T. Nguyen, MRI findings in deep infiltrating endometriosis: A pictorial essay. J Med Imaging Radiat Oncol, 2017. 61(6): p. 767-773. Corwin, M.T., et al., Differentiation of ovarian endometriomas from hemorrhagic cysts at MR imaging: utility of the T2 dark spot sign. Radiology, 2014. 271(1): p. 126-32. Guerriero, S., et al., Systematic approach to sonographic evaluation of the pelvis in women with suspected endometriosis, including terms, definitions and measurements: a consensus opinion from the International Deep Endometriosis Analysis (IDEA) group. Ultrasound Obstet Gynecol, 2016. 48(3): p. 318-32. Bazot, M., et al., European society of urogenital radiology (ESUR) guidelines: MR imaging of pelvic endometriosis. Eur Radiol, 2017. 27(7): p. 2765-2775. Yap, S.Z.L., et al., Pelvic MRI staging of endometriosis at 3T without patient preparation or anti-peristaltic: Diagnostic performance outcomes. Eur J Radiol, 2018. 105: p. 72-80. Morgan-Ortiz, F., et al., Clinical characteristics and location of lesions in patients with deep infiltrating endometriosis: using the revised Enzian classification. J Turk Ger Gynecol Assoc, 2018. Vercellini, P., et al., Endometriosis: pathogenesis and treatment. Nat Rev Endocrinol, 2014. 10(5): p. 261-75. Clement, P.B., The pathology of endometriosis: a survey of the many faces of a common disease emphasizing diagnostic pitfalls and unusual and newly appreciated aspects. Adv Anat Pathol, 2007. 14(4): p. 241-60. Brosens, I., et al., Non-invasive methods of diagnosis of endometriosis. Curr Opin Obstet Gynecol, 2003. 15(6): p. 519-22. Allen, B.C., et al., Practical Approach to MRI of Female Pelvic Masses. American Journal of Roentgenology, 2014. 202(6): p. 1366-1375. Hsu, A.L., I. Khachikyan, and P. Stratton, Invasive and noninvasive methods for the diagnosis of endometriosis. Clin Obstet Gynecol, 2010. 53(2): p. 413-9. De Cicco, C., et al., Bowel resection for deep endometriosis: a systematic review. BJOG, 2011. 118(3): p. 285-91. Bazot, M., et al., Deep pelvic endometriosis: MR imaging for diagnosis and prediction of extension of disease. Radiology, 2004. 232(2): p. 379-89. Jenkins, S., D.L. Olive, and A.F. Haney, Endometriosis: pathogenetic implications of the anatomic distribution. Obstet Gynecol, 1986. 67(3): p. 335-8. Kataoka, M.L., et al., Posterior cul-de-sac obliteration associated with endometriosis: MR imaging evaluation. Radiology, 2005. 234(3): p. 815-23. Manganaro, L., et al., Beyond laparoscopy: 3-T magnetic resonance imaging in the evaluation of posterior cul-de-sac obliteration. Magn Reson Imaging, 2012. 30(10): p. 1432-8. Novellas, S., et al., Anterior pelvic endometriosis: MRI features. Abdominal Imaging, 2010. 35(6): p. 742-749. Centini, G., et al., Effect of Anterior Compartment Endometriosis Excision on Infertility. Jsls, 2018. 22(4). Chapron, C., et al., Deep infiltrating endometriosis: relation between severity of dysmenorrhoea and extent of disease. Hum Reprod, 2003. 18(4): p. 760-6. Tan, C.H., et al., Pathways of extrapelvic spread of pelvic disease: imaging findings. Radiographics, 2011. 31(1): p. 117-33. Kim, S.W., et al., The prevesical space: anatomical review and pathological conditions. Clin Radiol, 2013. 68(7): p. 733-40. Auh, Y.H., et al., Extraperitoneal paravesical spaces: CT delineation with US correlation. Radiology, 1986. 159(2): p. 319-28. Auh, Y.H., et al., Intraperitoneal paravesical spaces: CT delineation with US correlation. Radiology, 1986. 159(2): p. 311-7. Kaniewska, M., et al., Suspensory Ligaments of the Female Genital Organs: MRI Evaluation with Intraoperative Correlation. Radiographics, 2018. 38(7): p. 2195-2211. Atlas of Deep Endometriosis, ed. A. Brandão, Crispi, Claudio Peixoto, Oliveira, Marco Aurélio Pinho 2018. Chamie, L.P., et al., Atypical Sites of Deeply Infiltrative Endometriosis: Clinical Characteristics and Imaging Findings. Radiographics, 2018. 38(1): p. 309-328. Gaeta, M., et al., Nuck canal endometriosis: MR imaging findings and clinical features. Abdom Imaging, 2010. 35(6): p. 737-41. Donnez, J., et al., Bladder endometriosis must be considered as bladder adenomyosis. Fertil Steril, 2000. 74(6): p. 1175-81. Chapron, C., et al., Deeply infiltrating endometriosis: pathogenetic implications of the anatomical distribution. Hum Reprod, 2006. 21(7): p. 1839-45. Busard, M.P., et al., MR imaging of bladder endometriosis and its relationship with the anterior uterine wall: experience in a tertiary referral centre. Eur J Radiol, 2012. 81(9): p. 2106-11. Chapron, C., et al., Surgery for bladder endometriosis: long-term results and concomitant management of associated posterior deep lesions. Hum Reprod, 2010. 25(4): p. 884-9. Kinkel, K., et al., Magnetic resonance imaging characteristics of deep endometriosis. Hum Reprod, 1999. 14(4): p. 1080-6. Umaria, N. and J.F. Olliff, Imaging features of pelvic endometriosis. Br J Radiol, 2001. 74(882): p. 556-62. Kinkel, K., et al., Diagnosis of endometriosis with imaging: a review. Eur Radiol, 2006. 16(2): p. 285-98. Leone Roberti Maggiore, U., et al., Bladder Endometriosis: A Systematic Review of Pathogenesis, Diagnosis, Treatment, Impact on Fertility, and Risk of Malignant Transformation. Eur Urol, 2017. 71(5): p. 790-807. Foti, P.V., et al., Endometriosis: clinical features, MR imaging findings and pathologic correlation. Insights Imaging, 2018. 9(2): p. 149-172. Balleyguier, C., et al., Ureteral endometriosis: the role of magnetic resonance imaging. J Am Assoc Gynecol Laparosc, 2004. 11(4): p. 530-6. Sillou, S., et al., Urinary endometriosis: MR imaging appearance with surgical and histological correlations. Diagn Interv Imaging, 2015. 96(4): p. 373-81. Maccagnano, C., et al., Ureteral endometriosis: proposal for a diagnostic and therapeutic algorithm with a review of the literature. Urol Int, 2013. 91(1): p. 1-9. Castaneda, C.V., et al., Endoscopic management of intraluminal ureteral endometriosis. Urology, 2013. 82(2): p. 307-12. Siegelman, E.S. and E.R. Oliver, MR imaging of endometriosis: ten imaging pearls. Radiographics, 2012. 32(6): p. 1675-91. Chapron, C., et al., Associated ovarian endometrioma is a marker for greater severity of deeply infiltrating endometriosis. Fertil Steril, 2009. 92(2): p. 453-7. Redwine, D.B., Ovarian endometriosis: a marker for more extensive pelvic and intestinal disease. Fertil Steril, 1999. 72(2): p. 310-5. Williams, J.C., et al., Association between kissing and retropositioned ovaries and severity of endometriosis: MR imaging evaluation. Abdom Radiol (NY), 2019. Glastonbury, C.M., The shading sign. Radiology, 2002. 224(1): p. 199-201. Kanso, H.N., et al., Variable MR findings in ovarian functional hemorrhagic cysts. J Magn Reson Imaging, 2006. 24(2): p. 356-61. Khashper, A., et al., T2-hypointense adnexal lesions: an imaging algorithm. Radiographics, 2012. 32(4): p. 1047-64. Davarpanah, A.H., et al., Diffusion MRI of uterine and ovarian masses: identifying the benign lesions. Abdom Radiol (NY), 2016. 41(12): p. 2466-2475. Marcal, L., et al., Deep pelvic endometriosis: MR imaging. Abdom Imaging, 2010. 35(6): p. 708-15. Ghezzi, F., et al., “Kissing ovaries”: a sonographic sign of moderate to severe endometriosis. Fertil Steril, 2005. 83(1): p. 143-7. Outwater, E.K., et al., Dilated fallopian tubes: MR imaging characteristics. Radiology, 1998. 208(2): p. 463-9. Kim, M.Y., et al., MR Imaging findings of hydrosalpinx: a comprehensive review. Radiographics, 2009. 29(2): p. 495-507. Rezvani, M. and A.M. Shaaban, Fallopian tube disease in the nonpregnant patient. Radiographics, 2011. 31(2): p. 527-48. Mattos, L.A., et al., Structured Ultrasound and Magnetic Resonance Imaging Reports for Patients with Suspected Endometriosis: Guide for Imagers and Clinicians. J Minim Invasive Gynecol, 2019. Kondo, W., et al., Complications after surgery for deeply infiltrating pelvic endometriosis. BJOG, 2011. 118(3): p. 292-8. Clement, P.B., PATHOLOGY OF ENDOMETRIOSIS. Pathology Annual, 1990. 25: p. 245-295. Bourgioti, C., et al., MR imaging of endometriosis: Spectrum of disease. Diagnostic and Interventional Imaging, 2017. 98(11): p. 751-767. Batt, R.E., D.C. Martin, and K. Odunsi, Endometriosis of the retrocervical septum is proposed to replace the anatomically incorrect term endometriosis of the rectovaginal septum. Hum Reprod, 2014. 29(12): p. 2603-5. Tang, X., et al., Deep infiltrating endometriosis MR imaging with surgical correlation. Quantitative Imaging in Medicine and Surgery, 2018. 8(2): p. 187-195. Audebert, A., et al., Anatomic distribution of endometriosis: A reappraisal based on series of 1101 patients. European Journal of Obstetrics and Gynecology and Reproductive Biology, 2018. 230: p. 36-40. Revised American Society for Reproductive Medicine classification of endometriosis: 1996. Fertil Steril, 1997. 67(5): p. 817-21. Piketty, M., et al., Preoperative work-up for patients with deeply infiltrating endometriosis: transvaginal ultrasonography must definitely be the first-line imaging examination. Hum Reprod, 2009. 24(3): p. 602-7. Andres, M.P., et al., Hormone treatment as first line therapy is safe and relieves pelvic pain in women with bowel endometriosis. Einstein (Sao Paulo), 2019. 17(2): p. eAO4583. Afors, K., et al., Segmental and Discoid Resection are Preferential to Bowel Shaving for Medium-Term Symptomatic Relief in Patients With Bowel Endometriosis. J Minim Invasive Gynecol, 2016. 23(7): p. 1123-1129. Dousset, B., et al., Complete surgery for low rectal endometriosis: long-term results of a 100-case prospective study. Ann Surg, 2010. 251(5): p. 887-95. Yoon, J.H., et al., Deep rectosigmoid endometriosis: “mushroom cap” sign on T2-weighted MR imaging. Abdom Imaging, 2010. 35(6): p. 726-31. Bong, J.W., et al., Intestinal endometriosis: Diagnostic ambiguities and surgical outcomes. World J Clin Cases, 2019. 7(4): p. 441-451. Rousset, P., et al., Bowel endometriosis: preoperative diagnostic accuracy of 3.0-T MR enterography--initial results. Radiology, 2014. 273(1): p. 117-24. Gustofson, R.L., et al., Endometriosis and the appendix: a case series and comprehensive review of the literature. Fertil Steril, 2006. 86(2): p. 298-303. Wolthuis, A.M., et al., Bowel endometriosis: colorectal surgeon’s perspective in a multidisciplinary surgical team. World J Gastroenterol, 2014. 20(42): p. 15616-23.

Acknowledgement

The authors would like to acknowledge Danielle Dobbs for creating the illustrations and Vanessa Allen for formatting and annotating the figures for this paper as part of Michigan Medicine Radiology Media Services. Author information Authors and Affiliations Corresponding author Additional information Publisher's Note Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations. Rights and permissions About this article Cite this article Jha, P., Sakala, M., Chamie, L.P. et al. Endometriosis MRI lexicon: consensus statement from the society of abdominal radiology endometriosis disease-focused panel. Abdom Radiol 45, 1552–1568 (2020). https://doi.org/10.1007/s00261-019-02291-x Published: Version of record: Issue date: DOI: https://doi.org/10.1007/s00261-019-02291-x

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mesh:D004715endometriosis

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Endometriosis Endometriosis Radiology Female Humans Magnetic Resonance Imaging Radiography

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