“…Solak et al reported no significant difference in size of lesions in the early days of menstruation compared to the mid-menstrual period for abdominal wall endometriosis [37]. Finally, Botterill et al did not observe a significant difference in disease extent between menstruating and non-menstruating scans [38]. Fig.…”
Endometriosis is a common gynaecological condition of unknown aetiology that primarily affects women of reproductive age. The accepted first-line imaging modality is pelvic ultrasound. However, magnetic resonance imaging (MRI) is increasingly performed as an additional investigation in complex cases and for surgical planning. There is currently no international consensus regarding patient preparation, MRI protocols or reporting criteria. Our aim was to develop clinical guidelines for MRI evaluation of pelvic endometriosis based on literature evidence and consensus expert opinion. This work was performed by a group of radiologists from the European Society of Urogenital Radiology (ESUR), experts in gynaecological imaging and a gynaecologist expert in methodology. The group discussed indications for MRI, technical requirements, patient preparation, MRI protocols and criteria for the diagnosis of pelvic endometriosis on MRI. The expert panel proposed a final recommendation for each criterion using Oxford Centre for Evidence Based Medicine (OCEBM) 2011 levels of evidence.Key Points• This report provides guidelines for MRI in endometriosis.• Minimal and optimal MRI acquisition protocols are provided.• Recommendations are proposed for patient preparation, best MRI sequences and reporting criteria.Electronic supplementary materialThe online version of this article (doi:10.1007/s00330-016-4673-z) contains supplementary material, which is available to authorized users.
“…Solak et al reported no significant difference in size of lesions in the early days of menstruation compared to the mid-menstrual period for abdominal wall endometriosis [37]. Finally, Botterill et al did not observe a significant difference in disease extent between menstruating and non-menstruating scans [38]. Fig.…”
Endometriosis is a common gynaecological condition of unknown aetiology that primarily affects women of reproductive age. The accepted first-line imaging modality is pelvic ultrasound. However, magnetic resonance imaging (MRI) is increasingly performed as an additional investigation in complex cases and for surgical planning. There is currently no international consensus regarding patient preparation, MRI protocols or reporting criteria. Our aim was to develop clinical guidelines for MRI evaluation of pelvic endometriosis based on literature evidence and consensus expert opinion. This work was performed by a group of radiologists from the European Society of Urogenital Radiology (ESUR), experts in gynaecological imaging and a gynaecologist expert in methodology. The group discussed indications for MRI, technical requirements, patient preparation, MRI protocols and criteria for the diagnosis of pelvic endometriosis on MRI. The expert panel proposed a final recommendation for each criterion using Oxford Centre for Evidence Based Medicine (OCEBM) 2011 levels of evidence.Key Points• This report provides guidelines for MRI in endometriosis.• Minimal and optimal MRI acquisition protocols are provided.• Recommendations are proposed for patient preparation, best MRI sequences and reporting criteria.Electronic supplementary materialThe online version of this article (doi:10.1007/s00330-016-4673-z) contains supplementary material, which is available to authorized users.
“…A moderately distended bladder is preferable because an overly distended bladder might lead to oversight in detecting small endometriosis of the bladder [ 9 ]. Regarding the timing of the menstrual cycle, Botterill et al [ 25 ] found no significant difference between menstruating and non-menstruating MRI scans for the evaluation of the extent or severity of endometriosis. An anti-peristaltic agent is recommended to prevent bowel motion artifacts, unless contraindicated [ 9 ].…”
Section: Role Of Mri and Optimal Mri Protocolmentioning
Endometriosis, a common chronic inflammatory disease in female of reproductive age, is closely related to patient symptoms and fertility. Because of its high contrast resolution and objectivity, MRI can contribute to the early and accurate diagnosis of ovarian endometriotic cysts and deeply infiltrating endometriosis without the need for any invasive procedure or radiation exposure. The ovaries, which are the most frequent site of endometriosis, can be afflicted by multiple related conditions and diseases. For the diagnosis of deeply infiltrating endometriosis and secondary adhesions among pelvic organs, fibrosis around the ectopic endometrial gland is usually found as a T2 hypointense lesion. This review summarizes the MRI findings obtained for ovarian endometriotic cysts and their physiologically and pathologically related conditions. This article also includes the key imaging findings of deeply infiltrating endometriosis.
“…All magnetic resonance images were acquired at 1.5T (Siemens Avanto, Germany) using a standardised protocol previously described. 13 Patients were positioned supine with a phased array surface coil. All patients received 20mg of intravenous (IV) hyoscine butylbromide (Buscopan) immediately prior to imaging to minimise bowel peristalsis.…”
Section: Imagingmentioning
confidence: 99%
“…14 Scans occurred irrespective of the patient's menstruation as this group have previously shown MRI accuracy is not affected by the menstrual cycle. 13,15 MRI features for the detection of DIE of the rectum are well described in the literature. 16,17 Lesion depth was determined by the presence of serosal thickening (serosal involvement), with muscular and submucosal invasion distinguished by the regularity or irregularity of the overlying T2 hyperintense mucosal layer.…”
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