Diagnosis of deep infiltrating endometriosis: accuracy of magnetic resonance imaging and transvaginal 3D ultrasonography

Rosario Francesco Grasso, di Giacomo V, Vincenza Di Giacomo, Sedati P, Pietro Sedati, Ornella Sizzi, Sizzi O, Florio G, Giuseppe Florio, Faiella E, Eliodoro Faiella, Alfonso Rossetti, Rossetti A, Riccardo Del Vescovo, Del Vescovo R, Bruno Beomonte Zobel, Zobel BB
Abdominal imaging · 2009 · vol. 35(6) , pp. 716–725 · doi:10.1007/s00261-009-9587-7 · PMID:19924468 · W2032171970
Diagnostic accuracy OA: closed CC0 ⤵ 82 in-corpus citations
Full text JSON View on OpenAlex View on PubMed View at publisher
⚙ AI-generated summary by gemini-2.5-flash-lite+body, 2026-06-12 ⓘ

Magnetic resonance imaging accurately diagnoses deep infiltrating endometriosis, while 3D ultrasonography accurately diagnoses it in specific pelvic locations.

One-sentence paraphrase of the abstract; not a substitute for reading it. No clinical advice. How this works

⚙ AI-generated deep summary by claude@2026-06, 2026-06-07 · read from full text ⓘ

This study compared magnetic resonance imaging (MRI) and transvaginal three-dimensional ultrasonography (3DUS) for preoperative mapping of deep infiltrating endometriosis in 33 women, with imaging of multiple pelvic sites (uterus torus/uterosacral ligaments, vagina, rectovaginal septum, rectosigmoid, bladder, and ovaries) and subsequent surgical and histopathological confirmation. MRI and 3DUS showed high specificity for several sites, but sensitivity varied markedly by location; for example, 3DUS sensitivity/specificity for deep disease were low for rectosigmoid and bladder (e.g., rectosigmoid 33.3% sensitivity, bladder 25% sensitivity) and higher for rectovaginal-septum (76.9%/100%) and USL (50%/94.7%). The paper’s major caveat is the small, single-cohort sample (n=33) evaluating site-by-site performance rather than an overall standardized extension metric. This paper is centrally about endometriosis — specifically, it assesses the diagnostic accuracy of MRI versus transvaginal 3D ultrasound for deep infiltrating endometriosis by anatomical site.

Read from the paper's body, not the abstract. Not a substitute for reading the paper. No clinical advice. How this works

Abstract

PURPOSE: To compare two different imaging modalities, magnetic resonance (MR), and three-dimensional sonography (3DUS), in order to evaluate the specific role in preoperative work-up of deep infiltrating endometriosis. MATERIALS AND METHODS: 33 women with endometriosis underwent 3DUS and MR followed by surgical and histopathological investigations. Investigators described the disease extension in the following sites: torus uterinus and uterosacral ligaments (USL), vagina, rectovaginal-septum, rectosigmoid, bladder, ovaries. Results were compared with surgical and histopathological findings. RESULTS: Ovarian and deep pelvic endometriosis were found by surgery and histology in, respectively, 24 (72.7%) and 22 (66.6%) of the 33 patients. Sensitivity and specificity values of 3DUS for the diagnosis of endometrial cysts were 87.5% and 100%, respectively; those of MRI were 96.8% and 91.1%, respectively. Sensitivity and specificity of 3DUS for the diagnosis of deep infiltrating endometriosis in specific sites were: USL 50% and 94.7%; vagina 84% and 80%; rectovaginal-septum 76.9% and 100%; rectosigmoid 33.3% and 100%; bladder 25% and 100%. Those of MR were: USL 69.2% and 94.3%; vagina 83.3% and 88.8%; rectovaginal-septum 76.4% and 100%; restosigmoid 75% and 100%; bladder 83.3% and 100%. CONCLUSIONS: MR accurately diagnoses deep infiltrating endometriosis; 3DUS accurately diagnoses deep infiltrating endometriosis in specific locations.
Full text 3,915 characters · extracted from oa-doi-fallback · 5 sections · click to expand

Abstract

Purpose To compare two different imaging modalities, magnetic resonance (MR), and three-dimensional sonography (3DUS), in order to evaluate the specific role in preoperative work-up of deep infiltrating endometriosis.

Materials and methods

33 women with endometriosis underwent 3DUS and MR followed by surgical and histopathological investigations. Investigators described the disease extension in the following sites: torus uterinus and uterosacral ligaments (USL), vagina, rectovaginal-septum, rectosigmoid, bladder, ovaries. Results were compared with surgical and histopathological findings.

Results

Ovarian and deep pelvic endometriosis were found by surgery and histology in, respectively, 24 (72.7%) and 22 (66.6%) of the 33 patients. Sensitivity and specificity values of 3DUS for the diagnosis of endometrial cysts were 87.5% and 100%, respectively; those of MRI were 96.8% and 91.1%, respectively. Sensitivity and specificity of 3DUS for the diagnosis of deep infiltrating endometriosis in specific sites were: USL 50% and 94.7%; vagina 84% and 80%; rectovaginal-septum 76.9% and 100%; rectosigmoid 33.3% and 100%; bladder 25% and 100%. Those of MR were: USL 69.2% and 94.3%; vagina 83.3% and 88.8%; rectovaginal-septum 76.4% and 100%; restosigmoid 75% and 100%; bladder 83.3% and 100%.

Conclusions

MR accurately diagnoses deep infiltrating endometriosis; 3DUS accurately diagnoses deep infiltrating endometriosis in specific locations. Similar content being viewed by others

References

Melis GB, Paoletti AM, Floris S (2005) Endometriosi. In: Nappi C (ed) Ostetricia e Ginecologia, vol II. Napoli: Idelson-Gnocchi, p 1153 Candiani GB, Fedele L, Vercellini P (1996) Malattia endometriosica. In: La clinica ostetrica e ginecologica, vol II. Milano: Masson, pp 1343–1377 Cornillie Fj, Oosterlynck D, Lauweryns JM, Koninckx PR (1990) Deeply infiltrating pelvic endometriosis: histology and clinical significance. Fertil Steril 53:978–983 Mais V, Guerriero S, et al. (1993) The efficiency of transvaginal ultrasonography in the diagnosis of endometrioma. Fertil Steril 60:776–780 Fedele L, Bianchi S, et al. (1997) Pre-operative assessment of bladder endometriosis. Hum Reprod 12:2519–2522 Bazot M, Thommasin I, Hourani R, Cortez A, Darai E (2004) Diagnostic accuracy of transvaginal sonography for deep pelvic endometriosis. Ultrasound Obstet Gynecol 24:180–185 Bazot M, Darai E, Hourani R, et al. (2004) Deep pelvic endometriosis: MR imaging for diagnosis and prediction of extension of disease. Radiology 232:379–389 Seow KM, et al. (2003) Transvaginal three dimensional ultrasonography combined with serum CA 125 level for the diagnosis of pelvic adhesions before laparoscopic surgery. J Am Assoc Gynecol Laparosc 10:320–326 Landis JR, Koch GG (1977) An application of hierarchical kappa-type statistics in the assessment of majority agreement among multiple observers. Biometrics 33(2):363–374 Bazot M, et al. (2003) Transvaginal sonography and rectal endoscopic sonography for the assessment of pelvic endometriosis: a preliminary comparison. Hum Reprod 18:1686–1692 Alcazar JL, Laparte C, Jurado M, Lopez-Garcia G (1997) The role of transvaginal ultrasonography combined with color velocity imaging and pulsed Doppler in the diagnosis of endometrioma. Fertil Steril 67:487–491 Balleyguier C, et al. (2002) Comparison of magnetic resonance imaging and transvaginal ultrasonography in diagnosing bladder endometriosis. J Am Assoc Gynecol Laparosc 9:15–23 Author information Authors and Affiliations Corresponding author Rights and permissions About this article Cite this article Grasso, R.F., Di Giacomo, V., Sedati, P. et al. Diagnosis of deep infiltrating endometriosis: accuracy of magnetic resonance imaging and transvaginal 3D ultrasonography. Abdom Imaging 35, 716–725 (2010). https://doi.org/10.1007/s00261-009-9587-7 Published: Issue date: DOI: https://doi.org/10.1007/s00261-009-9587-7

Text is read by the "Ask this paper" AI Q&A widget below. Extraction quality varies by source — PMC NXML preserves structure cleanly, OA-HTML may include some navigation residue, and OA-PDF can have broken hyphenation. The publisher copy (via DOI) is the canonical version.

My notes (saved in your browser only)

⚙ Ask this paper AI returns verbatim quotes from the full text · source: oa-doi-fallback ⓘ

Answers must be backed by verbatim quotes from this paper's full text. Hallucinated quotes are dropped automatically; if no verbatim passage answers the question, we say so. How this works

Condition tags

endometriosisdie_deep_infiltrating

MeSH descriptors

Endometriosis Endometriosis Imaging, Three-Dimensional Imaging, Three-Dimensional Magnetic Resonance Imaging Ultrasonography Adult Adult Contrast Media Contrast Media Diagnosis, Differential Diagnosis, Differential Endometriosis Endometriosis Endometriosis Female Female Gadolinium DTPA Gadolinium DTPA Humans

Citation neighborhood (2-hop)

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. Outer rings show 2-hop neighbours — papers reached through the immediate citers/citees. [ collapse to 1-hop ]

References (11)

Cited by (50)

Source provenance

europepmc
last seen: 2026-10-14T06:08:39.101224+00:00
openalex
last seen: 2026-06-10T17:14:06.276822+00:00
pubmed
last seen: 2026-10-08T21:07:04.513278+00:00
License: CC0 · commercial use OK