‘Fortune cookie sign’: a variant of mushroom cap sign on T2 weighted MRI for deep sigmoid endometriosis

Varela C, Cristian Varela, Cristián Varela, Maria Zulfiqar, Schiappacasse G, Giancarlo Schiappacasse, Christine O. Menias, Menias CO
Abdominal radiology (New York) · 2020 · vol. 46(3) , pp. 1272–1275 · doi:10.1007/s00261-020-02735-9 · PMID:32915269 · W3084702155
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⚙ AI-generated summary by claude@2026-06+body, 2026-06-12 ⓘ

This paper introduces the 'fortune cookie sign' as a variation of the 'mushroom cap sign' observed on T2-weighted MRI for diagnosing deep sigmoid endometriosis.

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⚙ AI-generated deep summary by claude@2026-06, 2026-06-12 · read from full text ⓘ

This paper describes a T2-weighted MRI imaging sign for deep sigmoid endometriosis, presenting the “fortune cookie sign” as a variant of the previously described “mushroom cap” sign. It focuses on how this specific MRI appearance is used in the radiologic assessment of deep sigmoid involvement, building on earlier reports of the mushroom cap sign for deep rectosigmoid endometriosis. The article provides limited methodological detail in the text provided and is presented as an imaging case report/description rather than a large comparative diagnostic study. This paper is centrally about endometriosis — it introduces and illustrates the “fortune cookie sign” MRI variant for deep sigmoid endometriosis.

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References Macafee CHG, Greer HLH. Intestinal endometriosis: A report of 29 cases and a survey of the literature. BJOG: An International Journal of Obstetrics & Gynaecology 1960; 67:539-555 Remorgida V, Ferrero S, Fulcheri E, Ragni N, Martin DC. Bowel endometriosis: presentation, diagnosis, and treatment. Obstetrical and gynecolocial Survey 2007; 62:461-470 De Cicco C, Corona R, Schonman R, Mailova K, Ussia A, Koninckx P. Bowel resection for deep endometriosis: a systematic review. BJOG: An International Journal of Obstetrics & Gynaecology 2011; 118:285-291 Chapron C, Chopin N, Borghese B, et al. Deeply infiltrating endometriosis: pathogenetic implications of the anatomical distribution. Human Reproduction 2006; 21:1839-1845 Yoon JH, Choi D, Jang KT, et al. Deep rectosigmoid endometriosis: “mushroom cap” sign on T2-weighted MR imaging. Abdom Imaging 2010; 35:726-731 Arévalo N, Méndez R. “Mushroom cap” sign in deep rectosigmoid endometriosis. Abdominal Radiology 2018; 43:3201-3203 Busard MPH, van der Houwen LEE, Bleeker MCG, et al. Deep infiltrating endometriosis of the bowel: MR imaging as a method to predict muscular invasion. Abdominal imaging 2012; 37:549-557 Valentini AL, Gui B, Miccò M, et al. How to improve MRI accuracy in detecting deep infiltrating colorectal endometriosis: MRI findings vs. laparoscopy and histopathology. Abdominal Radiology 2014; 119:291-297 Funding None. Author information Authors and Affiliations Corresponding author Ethics declarations Conflict of interest No relevant commercial or financial disclosures. Research involving human and animal rights This article does not contain any studies with human participants or animals performed by any of the authors. 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 Varela, C., Zulfiqar, M., Schiappacasse, G. et al. ‘Fortune cookie sign’: a variant of mushroom cap sign on T2 weighted MRI for deep sigmoid endometriosis. Abdom Radiol 46, 1272–1275 (2021). https://doi.org/10.1007/s00261-020-02735-9 Received: Revised: Accepted: Published: Version of record: Issue date: DOI: https://doi.org/10.1007/s00261-020-02735-9

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Condition tags

endometriosis

MeSH descriptors

Endometriosis Endometriosis Colon, Sigmoid Female Humans Magnetic Resonance Imaging

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.

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