Diagnosis of endometriosis with imaging: a review
Open accessAbstract
Endometriosis corresponds to ectopic endometrial glands and stroma outside the uterine cavity. Clinical symptoms include dysmenorrhoea, dyspareunia, infertility, painful defecation or cyclic urinary symptoms. Pelvic ultrasound is the primary imaging modality to identify and differentiate locations to the ovary (endometriomas) and the bladder wall. Characteristic sonographic features of endometriomas are diffuse low-level internal echos, multilocularity and hyperchoic foci in the wall. Differential diagnoses include corpus luteum, teratoma, cystadenoma, fibroma, tubo-ovarian abscess and carcinoma. Repeated ultrasound is highly recommended for unilocular cysts with low-level internal echoes to differentiate functional corpus luteum from endometriomas. Posterior locations of endometriosis include utero-sacral ligaments, torus uterinus, vagina and recto-sigmoid. Sonographic and MRI features are discussed for each location. Although ultrasound is able to diagnose most locations, its limited sensitivity for posterior lesions does not allow management decision in all patients. MRI has shown high accuracies for both anterior and posterior endometriosis and enables complete lesion mapping before surgery. Posterior locations demonstrate abnormal T2-hypointense, nodules with occasional T1-hyperintense spots and are easier to identify when peristaltic inhibitors and intravenous contrast media are used. Anterior locations benefit from the possibility of MRI urography sequences within the same examination. Rare locations and possible transformation into malignancy are discussed.
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MRI is a useful modality for presurgical mapping of deep pelvis endometriosis with sensitivity 90-92% and specificity 91-98%.
“A study said that MRI is a useful modality for presurgical mapping of deep pelvis endometriosis with sensitivity and specificity that could reach 90%–92% and 91%–98%, respectively [18].”
From Case report: Caesarean scar endometriosis – A rare entity (2021) · cites this paper as [18]
Kinkel et al. revealed the sensitivity and specificity of MRI in diagnosing endometriomas to be 90-92% and 91-98%, respectively.
“Kinkel et al. revealed the sensitivity and specificity of MRI in diagnosing endometriomas to be 90-92% and 91-98%, respectively.13”
From Scar endometriosis: A series of 3 cases (2016) · cites this paper as [13]
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- Authors
- Kinkel, K., Frei, K. A., Balleyguier, C., & Chapron, C.
- Affiliations
- Fondation des Grangettes (CH)
- University Hospital of Bern (CH)
- Institut Gustave Roussy (FR)
- Hôpital Cochin (FR)
- Corresponding author
- Kinkel, Karen
- Venue
- European Radiology
- Published
- 2005-09-10
- Volume
- 16
- Issue
- 2
- Pages
- 285-298
- ISSN
- 0938-7994 (ISSN-L)
- 1432-1084
- OpenAlex
- W2078042686
- Cited by
- 321
- References
- 72
- Citations by year
- 2026: 8 · 2025: 12 · 2024: 13 · 2023: 9 · 2022: 15 · 2021: 18 · 2020: 26 · 2019: 17 · 2018: 10 · 2017: 16 · 2016: 12 · 2015: 19 · 2014: 22 · 2013: 17 · 2012: 21
- FWCI
- 1.94
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Licence
- www.springer.com/tdm (tdm)
- Locations
- European Radiology (publishedVersion)
- PubMed (publishedVersion)
- BORIS (University Library Bern) (submittedVersion, other-oa)
- Open Access CRIS of the University of Bern
- Topics
- Health Sciences › Medicine › Reproductive Medicine › Endometriosis Research and Treatment
- Health Sciences › Medicine › Obstetrics and Gynecology › Gynecological conditions and treatments
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Ectopic Pregnancy Diagnosis and Management
- Keywords
- endometriosis, endometrioma, pelvic ultrasound, magnetic resonance imaging, corpus luteum, differential diagnosis, lesion mapping
- MeSH terms
- Urinary Bladder, Broad Ligament, Diagnosis, Differential, Endometriosis, Female, Humans, Image Processing, Computer-Assisted, Magnetic Resonance Imaging, Ovary, Rectum, Sensitivity and Specificity, Colon, Sigmoid, Ultrasonography, Uterus, Vagina
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
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