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Cited by 79Endometriosis Research and TreatmentGynecological conditions and treatmentsOmental and Epiploic Conditions

Appearance of abdominal wall endometriosis on MR imaging

Open access
Busard, Milou P. H., Mijatovic, Velja, van Kuijk, Cees, Hompes, Peter G. A., van Waesberghe, Jan Hein T. M.·2010·European Radiology
DOI 10.1007/s00330-009-1658-1PMC PMC2850520
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Abstract

OBJECTIVE: Abdominal wall endometriosis (AWE) is defined as endometrial tissue that is superficial to the peritoneum. AWE is often difficult to diagnose, mimicking a broad spectrum of diseases. The aim of this study was to describe the appearance of AWE on magnetic resonance (MR) imaging. METHODS: We present ten patients with AWE (12 lesions) in which MR imaging was used for diagnosis. MR imaging included T2-weighted imaging and T1-weighted imaging with fat suppression. To assess the value of diffusion-weighted imaging (DWI) in endometriosis, four patients underwent additional DWI. The apparent diffusion coefficient (ADC) was calculated using b values of 50, 400, 800 and 1,200 s/mm(2). RESULTS: In most cases, the lesion was located ventral or dorsal to the aponeurosis of the rectus oblique muscle (n = 6) or in the rectus abdominis (n = 5). MR of AWE lesions showed isointense or slightly hyperintense signal compared with muscle on T2-weighted images and showed isointense or slightly hyperintense signal compared with muscle on T1-weighted images with foci of high signal intensity, indicative of haemorrhage. The mean ADC value of AWE was 0.93 x 10(-3)/mm(2)/s. CONCLUSION: MR imaging seems to be useful in determining the location and depth of infiltration in surrounding tissue preoperatively.

AI snapshot

Written from the paper’s full text.

TL;DR

This case series describes MR imaging features of abdominal wall endometriosis (AWE) in ten patients with 12 lesions, using T2-weighted, fat-suppressed T1-weighted, and diffusion-weighted imaging in a subset. MR localized lesions and showed characteristic signal abnormalities, with a mean ADC of 0.93 × 10⁻³/mm²/s in five AWE lesions.

Key findings

  • In 10 patients with AWE (12 lesions), lesions were most often located in the rectus abdominis (n = 5) or ventral/dorsal to the aponeurosis of the rectus oblique muscle (n = 6); one lesion was in an abdominal wall hernia. Eight of ten lesions were at a surgery scar corner site.
  • On T2-weighted imaging, AWE lesions were isointense or hyperintense compared with muscle, with foci of high signal intensity in eight lesions; on fat-suppressed T1-weighted imaging, lesions were isointense or slightly hyperintense compared with muscle, with small high-intensity foci in five lesions.
  • Mean ADC value of five AWE lesions was 0.93 × 10⁻³/mm²/s (range 0.79–1.10 × 10⁻³/mm²/s); the cystic part of one AWE lesion had an ADC of 1.42 × 10⁻³/mm²/s, while bladder endometriosis, fornix endometriosis, and adenomyosis showed ADC values of 0.57, 0.84, and 0.71 × 10⁻³/mm²/s, respectively.
  • The authors conclude MR imaging seems useful for determining the location and depth of infiltration in surrounding tissue preoperatively.

Methods

  • Observational case series: between March 2007 and March 2009, 10 of 246 consecutive patients visiting an outpatient MR clinic for suspected or known deep infiltrating endometriosis were diagnosed with AWE.
  • MR imaging at 1.5 T included T2-weighted TSE and fat-suppressed T1-weighted sequences in multiple planes; four patients also underwent diffusion-weighted imaging with b values of 50, 400, 800, and 1,200 s/mm², and ADC values were calculated using a region of interest of at least 30 mm².
  • Lesions were analyzed for location, size, and appearance on T2-weighted and fat-suppressed T1-weighted images; diagnosis was based on cyclical symptoms related to menstrual periods and MR showing blood products within a focal abdominal wall lesion.

Limitations

  • Stated: small numbers of patients, no earlier studies on ADC values in deep infiltrating endometriosis, and more studies are needed to assess the value of DWI in differentiating DIE from other pathologies. The authors also note possible bias because their hospital is a tertiary referral centre for endometriosis, which may explain the 46% rate of subsequent pelvic endometriosis or adenomyosis.
  • Evident from the text: this is a single-centre case series without a control or comparison group, DWI was performed in only four patients (five lesions), and not all lesions had surgical histologic confirmation.

Model-written summary. Check it against the paper before relying on it.

Integrity signals

Registry

Crossref · 10.1007/s00330-009-1658-1

Cites

33 of 33 references verified0 citation errors · 0 not checkable

Statistics

Nothing to recompute.

Claims the paper makes

0 of 40 cited sources checked · 0 supported · 0 flagged

  • Findingown data

    The size of the lesions ranged from 16 × 9 mm to 30 × 17 mm in the axial plane and from 14 mm to 57 mm in the craniocaudal plane.

    “The size of the lesions ranged from 16 × 9 mm to 30 × 17 mm in the axial plane and from 14 mm to 57 mm in the craniocaudal plane.”
    Quote in the paperNot a substantial claim
  • Findingown data

    Eight out of ten lesions were found at the corner site of the surgery scar.

    “Eight out of ten lesions were found at the corner site of the surgery scar.”
    Quote in the paperNot a substantial claim
  • Findingown data

    One endometriotic lesion, both cystic and solid, was located in a herniation of the abdominal wall.

    “In one extraordinary case, an endometriotic lesion, both cystic and solid, was located in a herniation of the abdominal wall (Fig. 4).”
    Quote in the paperNot a substantial claim
  • Findingown data

    Twelve AWE lesions were found and analysed.

    “Twelve AWE lesions were found and analysed.”
    Quote in the paperNot a substantial claim
  • Findingown data

    Ten out of 246 consecutive patients visiting the outdoor MR clinic for suspected or known deep infiltrating endometriosis were diagnosed with AWE.

    “Between March 2007 and March 2009, ten out of 246 consecutive patients visiting our outdoor MR clinic for the analysis of suspected or known deep infiltrating endometriosis, were diagnosed with AWE.”
    Quote in the paperNot a substantial claim
  • May combine two claims. 18
  • Classified as probably not a substantial claim. 17

  • May combine two claims.

    Findingown data

    The mean largest diameter in the axial plane was 24 mm and mean largest diameter in the craniocaudal plane was 27 mm.

    “The mean largest diameter in the axial plane was 24 mm and mean largest diameter in the craniocaudal plane was 27 mm.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Findingown data

    Two patients presented with spontaneous AWE located in the right and left groins, respectively.

    “Two patients presented with spontaneous AWE located in the right and left groins, respectively (Fig. 2).”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Findingown data

    Other lesions were found in the right corner of a trocar insertion scar, in the caudal corner of a median incision scar, and more centrally in a hernia located in a median laparotomy scar.

    “The other lesions were found in the right corner of a trocar insertion scar, in the caudal corner of a median incision scar and more centrally in a hernia located in a median laparotomy scar.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Findingown data

    Two surgery scar lesions contained large cystic components, showing homogeneously high signal intensity on T1-weighted imaging with fat saturation.

    “Two surgery scar lesions contained large cystic components, showing homogeneously high signal intensity on T1-weighted imaging with fat saturation, indicative of haemorrhagic cysts (Fig. 5).”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Findingown data

    In Pfannenstiel incision scars, four lesions were located in the left corner, two in the right corner, and one more centrally.

    “In the Pfannenstiel incision scars, four lesions were located in the left corner, two in the right corner and one (second lesion) more centrally (Fig. 1).”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Findingown data

    On T1-weighted imaging with fat-suppression, lesions appeared isointense or slightly hyperintense compared with muscle, with small foci of high intensity in five lesions.

    “On T1-weighted imaging with fat-suppression, lesions appeared isointense or slightly hyperintense compared with muscle, with small foci of high intensity in five lesions.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Findingown data

    In our study MR imaging, performed because of clinical suspicion of AWE, confirmed the diagnosis and showed the relation of AWE to the rectus abdominis and the aponeurosis of the rectus oblique muscle.

    “In our study MR imaging, performed because of clinical suspicion of AWE, confirmed the diagnosis and showed the relation of AWE to the rectus abdominis and the aponeurosis of the rectus oblique muscle.”
    Quote in the paperSubstantial claim

  • May combine two claims.

    Findingown data

    ADC values of bladder endometriosis, endometriosis located at the fornix, and adenomyosis were 0.57, 0.84, and 0.71 × 10-3/mm2/s, respectively.

    “ADC values of bladder endometriosis, endometriosis located at the fornix and adenomyosis showed ADC values of 0.57 × 10–3/mm2/s, 0.84 × 10–3/mm2/s and 0.71 × 10–3/mm2/s, respectively.”
    Quote in the paperNot a substantial claim

  • Classified as probably not a substantial claim.

    Findingown data

    In our study, the surgeons involved did not show a preferred table position, when asked.

    “In our study, the surgeons involved did not show a preferred table position, when asked.”
    Quote in the paperSubstantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing), S4 (based). May combine two claims.

    Findingnone given

    DIE located at the bladder wall and fornix posterior as well as adenomyosis showed lower ADC values.

    “DIE located at the bladder wall and fornix posterior as well as adenomyosis showed lower ADC values.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Findingown data

    Contrary to a previous study in which no higher predilection for pelvic endometriosis (13%) was found in AWE, 46% of our patients showed subsequent pelvic endometriosis or adenomyosis on MR imaging.

    “Contrary to a previous study in which no higher predilection for pelvic endometriosis (13%) was found in AWE, 46% of our patients showed subsequent pelvic endometriosis or adenomyosis on MR imaging [2].”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [2] Horton JD, Dezee KJ, Ahnfeldt EP, Wagner M (2008) Abdominal wall endometriosis: a surgeon’s perspective and review of 445 cases. Am J Surg 196:207–212 source

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

    Premisecitation

    Abdominal wall endometriosis (AWE) is a common site of extra-pelvic endometriosis usually developing in a surgical abdominal scar, with an incidence of 0.1%.

    “Abdominal wall endometriosis (AWE) is a common site of extra-pelvic endometriosis usually developing in a surgical abdominal scar with an incidence of 0.1% [1].”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [1] Balleyguier C, Chapron C, Chopin N, Helenon O, Menu Y (2003) Abdominal wall and surgical scar endometriosis: results of magnetic resonance imaging. Gynecol Obstet Investig 55:220–224 source

      Not checked in the free run.

  • Classified as probably not a substantial claim. May combine two claims.

    Premisecitation

    US findings are often non-specific, and a wide spectrum of disorders presenting as a mass in the abdominal wall should be considered in the imaging differential diagnosis.

    “US findings are often non-specific, and a wide spectrum of disorders presenting as a mass in the abdominal wall should be considered in the imaging differential diagnosis [7].”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites [7] Hensen JH, Van B V, Puylaert JB (2006) Abdominal wall endometriosis: clinical presentation and imaging features with emphasis on sonography. AJR Am J Roentgenol 186:616–620 source

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

    Premisecitation

    Regarding endometrial cysts, previous studies found a tendency towards lower ADC values compared with other pelvic cysts, which might be more closely related to blood concentration.

    “Regarding endometrial cysts, previous studies found a tendency towards lower apparent diffusion coefficient (ADC) values compared with other pelvic cysts, which might be more closely related to blood concentration [19–21].”
    Quote in the paperNot a substantial claim0 of 3 sources checked
    • cites [19] Katayama M, Masui T, Kobayashi S, Ito T, Sakahara H, Nozaki A et al (2002) Diffusion-weighted echo planar imaging of ovarian tumors: is it useful to measure apparent diffusion coefficients? J Comput Assist Tomogr 26:250–256 source

      Not checked in the free run.

    • cites [20] Moteki T, Ishizaka H (2000) Diffusion-weighted EPI of cystic ovarian lesions: evaluation of cystic contents using apparent diffusion coefficients. J Magn Reson Imaging 12:1014–1019 source

      Not checked in the free run.

    • cites [21] Nakayama T, Yoshimitsu K, Irie H, Aibe H, Tajima T, Nishie A et al (2005) Diffusion-weighted echo-planar MR imaging and ADC mapping in the differential diagnosis of ovarian cystic masses: usefulness of detecting keratinoid substances in mature cystic teratomas. J Magn Reson Imaging 22:271–278 source

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Premisecitation

    Intracystic blood clots floating in or attached to the wall of endometrial cysts showed a mean ADC value of 1.11 × 10-3/mm2/s.

    “Intracystic blood clots floating in or attached to the wall of endometrial cysts showed a mean value of 1.11 × 10–3/mm2/s [22].”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [22] Fujii S, Kakite S, Nishihara K, Kanasaki Y, Harada T, Kigawa J et al (2008) Diagnostic accuracy of diffusion-weighted imaging in differentiating benign from malignant ovarian lesions. J Magn Reson Imaging 28:1149–1156 source

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Premisecitation

    DWI may be useful for differentiating tumours according to their different cellular construction.

    “In addition, diffusion-weighted imaging (DWI) may be useful for differentiating tumours according to their different cellular construction [18].”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [18] Yamashita Y, Tang Y, Takahashi M (1998) Ultrafast MR imaging of the abdomen: echo planar imaging and diffusion-weighted imaging. J Magn Reson Imaging 8:367–374 source

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

    Premisecitation

    In these studies, endometriosis appeared homogeneously hypointense or isointense, or heterogeneous with focal areas of high and low signal intensity, suggesting old haemorrhage or fibrosis on T2-weighted and T1-weighted fat-suppressed imaging.

    “In these studies, endometriosis appeared homogeneously hypointense or isointense, or heterogeneous with focal areas of high and low signal intensity, suggesting old haemorrhage or fibrosis on T2-weighted and T1-weighted fat-suppressed imaging.”
    Quote in the paperNot a substantial claim0 of 6 sources checked
    • cites [1] Balleyguier C, Chapron C, Chopin N, Helenon O, Menu Y (2003) Abdominal wall and surgical scar endometriosis: results of magnetic resonance imaging. Gynecol Obstet Investig 55:220–224 source

      Not checked in the free run.

    • cites [7] Hensen JH, Van B V, Puylaert JB (2006) Abdominal wall endometriosis: clinical presentation and imaging features with emphasis on sonography. AJR Am J Roentgenol 186:616–620 source

      Not checked in the free run.

    • cites [14] Onbas O, Kantarci M, Alper F, Kumtepe Y, Durur I, Ingec M et al (2007) Nodular endometriosis: dynamic MR imaging. Abdom Imaging 32:451–456 source

      Not checked in the free run.

    • cites [15] Pados G, Tympanidis J, Zafrakas M, Athanatos D, Bontis JN (2008) Ultrasound and MR-imaging in preoperative evaluation of two rare cases of scar endometriosis. Cases J 1:97 source

      Not checked in the free run.

    • cites [16] Wolf GC, Kopecky KK (1989) MR imaging of endometriosis arising in cesarean section scar. J Comput Assist Tomogr 13:150–152 source

      Not checked in the free run.

    • cites [17] Yu CY, Perez-Reyes M, Brown JJ, Borrello JA (1994) MR appearance of umbilical endometriosis. J Comput Assist Tomogr 18:269–271 source

      Not checked in the free run.

  • Classified as probably not a substantial claim.

    Premisecitation

    CT should not be used for the detection of AWE because of its lack of contrast resolution and its radiation exposure.

    “CT should not be used for the detection of AWE, because of its lack of contrast resolution and its radiation exposure [13].”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites [13] Dwivedi AJ, Agrawal SN, Silva YJ (2002) Abdominal wall endometriomas. Dig Dis Sci 47:456–461 source

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Premisecitation

    Previously MR accurately predicted deep infiltrating endometriosis.

    “Previously MR accurately predicted deep infiltrating endometriosis [30].”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [30] Bazot M, Darai E, Hourani R, Thomassin I, Cortez A, Uzan S et al (2004) Deep pelvic endometriosis: MR imaging for diagnosis and prediction of extension of disease. Radiology 232:379–389 source

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S2 (checkable).

    Interpretationnone given

    AWE should be suspected in any female patient with cyclical pain from a mass in scar tissue, an abdominal hernia or the inguinal region.

    “In conclusion, AWE should be suspected in any female patient with cyclical pain from a mass in scar tissue, an abdominal hernia or the inguinal region.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Premisecitation

    In most patients, nodular fasciitis or desmoid tumours are excluded from the differential diagnosis, because in general these patients do not present with a mass in or close to a scar, pain symptoms during menstruation or continuous pain symptoms, as patients in our study did.

    “However, in most patients, nodular fasciitis or desmoid tumours are excluded from the differential diagnosis, because in general these patients do not present with a mass in or close to a scar, pain symptoms during menstruation or continuous pain symptoms [26], as patients in our study did.”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [26] Grobmyer SR, Knapik JA, Foss RM, Copeland EM, Hochwald SN (2009) Nodular fasciitis: differential considerations and current management strategies. Am Surg 75:610–614 source

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Premisecitation

    No other pathological conditions were present in Onbas et al.'s patient population.

    “However, no other pathological conditions were present in their patient population.”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [14] Onbas O, Kantarci M, Alper F, Kumtepe Y, Durur I, Ingec M et al (2007) Nodular endometriosis: dynamic MR imaging. Abdom Imaging 32:451–456 source

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Interpretationreasoning

    This might be due to a bias of patients with deep infiltrating endometriosis at our hospital, which is a tertiary referral centre for endometriosis in The Netherlands.

    “This might be due to a bias of patients with deep infiltrating endometriosis at our hospital, which is a tertiary referral centre for endometriosis in The Netherlands.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

    Premisecitation

    Teng et al. reported that endometriosis in a Pfannenstiel incision scar was found more often at the right corner of the surgery scar (68%), possibly because of the predominance of operators standing on their patient's right side during surgery and endometrial inoculums not being easily found and removed on that side.

    “They reported that endometriosis in a Pfannenstiel incision scar was found more often at the right corner of the surgery scar (68%), possibly because of the predominance of operators standing on their patient’s right side during surgery and endometrial inoculums not being easily found and removed on that side.”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [27] Teng CC, Yang HM, Chen KF, Yang CJ, Chen LS, Kuo CL (2008) Abdominal wall endometriosis: an overlooked but possibly preventable complication. Taiwan J Obstet Gynecol 47:42–48 source

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Premisecitation

    Onbas et al. demonstrated that contrast-enhanced dynamic MR imaging (DMI) in a small number of patients (n = 8) with suspected AWE may support its diagnosis, based on the similar vascularity of endometriomas and endometrial tissue.

    “Onbas et al. [14] demonstrated that contrast-enhanced dynamic MR imaging (DMI) in a small number of patients (n = 8) with suspected AWE may support its diagnosis, based on the similar vascularity of endometriomas and endometrial tissue.”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [14] Onbas O, Kantarci M, Alper F, Kumtepe Y, Durur I, Ingec M et al (2007) Nodular endometriosis: dynamic MR imaging. Abdom Imaging 32:451–456 source

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

    Premisecitation

    In endometrial cysts the age of blood influences the viscosity and may therefore influence the ADC value.

    “In endometrial cysts the age of blood influences the viscosity [24] and may therefore influence the ADC value.”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [24] Takahashi K, Okada S, Okada M, Kitao M, Kaji Y, Sugimura K (1996) Magnetic resonance relaxation time in evaluating the cyst fluid characteristics of endometrioma. Hum Reprod 11:857–860 source

      Not checked in the free run.

  • May combine two claims.

    Interpretationown data

    ADC values may help to diagnose AWE, although more studies are needed to confirm this.

    “ADC values may help to diagnose AWE, although more studies are needed to confirm this.”
    Quote in the paperSubstantial claim

  • May combine two claims.

    Premisecitation

    We did not use intravenous contrast, as previous studies demonstrated enhancement of AWE lesions on post-contrast T1-weighted images was not specific.

    “We did not use intravenous contrast, as previous studies demonstrated enhancement of AWE lesions on post-contrast T1-weighted images was not specific [7, 31–33].”
    Quote in the paperSubstantial claim0 of 4 sources checked
    • cites [7] Hensen JH, Van B V, Puylaert JB (2006) Abdominal wall endometriosis: clinical presentation and imaging features with emphasis on sonography. AJR Am J Roentgenol 186:616–620 source

      Not checked in the free run.

    • cites [31] Cervini P, Mahoney J, Wu L (2005) Endometriosis in the canal of Nuck: atypical manifestations in an unusual location. AJR Am J Roentgenol 85:284–285 source

      Not checked in the free run.

    • cites [32] Keyserling HF, Castillo M, Smith JK (2003) Cranial fasciitis of childhood. AJNR Am J Neuroradiol 24:1465–1467

      Not checked in the free run.

    • cites [33] Dinauer PA, Brixey CJ, Moncur JT, Fanburg-Smith JC, Murphey MD (2007) Pathologic and MR imaging features of benign fibrous soft-tissue tumors in adults. Radiographics 27:173–187 source

      Not checked in the free run.

28 of 28

  • The paper relies on this without support.

    AWE is often difficult to diagnose, mimicking a broad spectrum of diseases.

    “AWE is often difficult to diagnose, mimicking a broad spectrum of diseases.”

  • The paper relies on this without support.

    No previous studies exist describing DWI in deep infiltrating endometriosis (DIE), including AWE.

    “To our knowledge, however, no previous studies exist describing DWI in deep infiltrating endometriosis (DIE), including AWE.”

  • The authors state this as an assumption.

    Foci of high signal intensity on T1-weighted fat-suppressed images correlate with small haemorrhages.

    “On the T1-weighted images with fat suppression these foci of high signal intensity are assumed to correlate with small haemorrhages.”
3 of 3

Claims other papers make about this one

Each is checked against this paper’s own text: does it say what the citing paper says it does?

  • Needle-biopsy is essential to establish the diagnosis of AWE.

    “whereas needle-biopsy is essential to establish the diagnosis of AWE [12–14].”

    From Trocar scar abdominal wall adenomyoma following laparoscopic hysterectomy: case report (2024) · cites this paper as [12]

    The Introduction (page not provided) describes needle aspiration as a useful way to confirm AWE, but says its results are often inconclusive. The Discussion (page not provided) says MR imaging confirmed the diagnosis in this study. The paper therefore does not treat needle biopsy as essential to establishing the diagnosis. (LLM, conf=0.86)

    Checked by a reasoning model — may be wrong.

    Experimental — accuracy not yet measured

  • Ultrasonography and MRI help to understand the intrinsic characteristics of the mass and its relationships with abdominal wall anatomy.

    “Ultrasonography and MRI help to understand the intrinsic characteristics of the mass as well as its relationships with abdominal wall anatomy”

    From Trocar scar abdominal wall adenomyoma following laparoscopic hysterectomy: case report (2024) · cites this paper as [12]

    The Results describe MRI findings that characterize the lesion, and the Discussion says MRI showed its relationship to the rectus abdominis and aponeurosis. The Introduction mentions ultrasonography but says its findings are often nonspecific; this paper does not establish the same claimed benefit for ultrasonography. Page numbers are unavailable in our copy. (LLM, conf=0.86)

    Experimental — accuracy not yet measured

  • The existing literature on CT features of abdominal wall endometriosis is limited to case reports, with CT features often described as nonspecific with variable attenuation and enhancement characteristics.

    “While some have studied sonographic features of AWE (5,6,7,8,9,10), the existing literature on CT is limited to case reports, with CT features often described as nonspecific with variable attenuation and enhancement characteristics (4,5,7,8,11).”

    From Abdominal wall endometriosis: differentiation from other masses using CT features (2017) · cites this paper as [7]

Self-check

Percentages, sums and reported differences re-computed from the paper’s own numbers.

Each contradiction between two passages listed here was confirmed by an independent check.

  • DWI lesions are described both as lacking and having a cystic component

    Minor

    The results say the five AWE lesions with reported ADC values had no cystic components. The discussion, describing DWI in four patients with five lesions, reports an ADC value from the cystic part of an AWE lesion.

1 of 1

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Authors
Busard, M. P. H., Mijatovic, V., van Kuijk, C., Hompes, P. G. A., & van Waesberghe, J. H. T. M.
Affiliations
Amsterdam UMC Location Vrije Universiteit Amsterdam (NL)
Corresponding author
Busard, Milou P. H.
ORCID
Mijatovic, Velja
Venue
European Radiology
Publisher
Springer Science and Business Media LLC
Published
2009-11-21
Volume
20
Issue
5
Pages
1267-1276
ISSN
  • 0938-7994 (ISSN-L)
  • 1432-1084
DOI
10.1007/s00330-009-1658-1
PMC
PMC2850520
OpenAlex
W2125494348
Cited by
79
References
33
Citations by year
2026: 1 · 2025: 3 · 2024: 7 · 2023: 7 · 2022: 6 · 2021: 2 · 2020: 4 · 2019: 7 · 2018: 3 · 2017: 7 · 2016: 3 · 2015: 5 · 2014: 6 · 2013: 6 · 2012: 9
FWCI
4.71
Type
journal article
Language
en
Open access
Licence
cc-by-nc
Locations
  • European Radiology (publishedVersion, cc-by-nc)
  • PubMed Central (publishedVersion, cc-by-nc)
  • PubMed (publishedVersion)
  • Pure Amsterdam UMC (submittedVersion, other-oa)
  • Amsterdam UMC (VU Amsterdam) - Institutional Repository (submittedVersion, other-oa)
  • Digital Academic REpository of VU University Amsterdam (Vrije Universiteit Amsterdam) (submittedVersion)
  • Data Archiving and Networked Services (DANS) (submittedVersion, other-oa)
Topics
  • Health Sciences › Medicine › Reproductive Medicine › Endometriosis Research and Treatment
  • Health Sciences › Medicine › Obstetrics and Gynecology › Gynecological conditions and treatments
  • Health Sciences › Medicine › Rheumatology › Omental and Epiploic Conditions
Keywords
abdominal wall endometriosis, magnetic resonance imaging, diffusion-weighted imaging, apparent diffusion coefficient, rectus abdominis, hemorrhage, preoperative diagnosis, depth of infiltration
MeSH terms
Adult, Endometriosis, Female, Humans, Image Interpretation, Computer-Assisted, Magnetic Resonance Imaging, Abdominal Wall, Diffusion Magnetic Resonance Imaging

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