MR diagnosis of diaphragmatic endometriosis
Abstract
Purpose To evaluate magnetic resonance imaging (MRI) for diaphragmatic endometriosis diagnosis.Materials and methods Over a 2-year period, all diaphragmatic MRI performed in the context of diaphragmatic endometriosis were reviewed. Axial and coronal fat-suppressed T1- and T2-weighted sequences were analyzed by two independent readers for the presence of nodules, plaque lesions, micronodule clustering, or focal liver herniation. MR abnormalities were correlated to surgical findings in women surgically treated. Interobserver agreement was assessed by κ statistics.Results Twenty-three women with diaphragmatic endometriosis criteria comprised the population; 14 had surgical confirmation and nine had symptoms relief with hormonal treatment. MRI sensitivity was 83 % (19/23; 95 % confidence interval [CI]: 68, 98) for reader 1 and 78 % (18/23; 95 % CI: 61, 95) for reader 2. Kappa value was 0.86 (95 % CI: 0.47, 1.00). Readers 1 and 2 detected 35 and 36 lesions, respectively, all right-sided and agreed for 32 lesions on the type, location, and signal. Lesions were mostly nodules (23/32, 72 %), predominantly posterior (28/32, 87.5 %) and hyperintense on T1 (20/32, 63 %). MRI was negative for both readers in 2 surgically treated patients with small nodules or isolated diaphragmatic holes.Conclusion MRI allows diaphragmatic endometriosis diagnosis with 78 to 83 % sensitivity and excellent interobserver agreement.Key points • MRI allows the diagnosis of diaphragmatic endometriosis with up to 83 % sensitivity. • Diaphragmatic endometriosis lesions are better depicted on fat-suppressed T1-weighted sequences. • Diaphragmatic lesions, mostly hyperintense nodules, are right-sided and predominantly posterior. • MRI can help in timely diagnosis of diaphragmatic endometriosis.
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Despite low specificity, CXR and CT are the most sensitive tests for detection of pneumothorax and hemothorax, whereas MRI is preferable for detection of diaphragmatic endometriosis with a reported sensitivity of 78%-83%.
“Despite low specificity, the most sensitive tests for detection of pneumothorax and hemothorax are CXR and CT, whereas MRI is preferable for the detection of diaphragmatic endometriosis with a reported sensitivity of 78%–83%.39–42”
From Thoracic Endometriosis Syndrome: A Review of Diagnosis and Management (2019) · cites this paper as [41]
MRI has been reported to be superior to CT in diagnosing diaphragmatic, pleural, and hemorrhagic lesions with a reported sensitivity of 83% overall.
“MRI has been reported to be superior to CT in diagnosing diaphragmatic, pleural, and hemorrhagic lesions with a reported sensitivity of 83% overall.”
From Extra-pelvic endometriosis: a review. (2020) · cites this paper as [86]
The reported sensitivity for diaphragmatic endometriosis by MRI is 78-83% when using fat-suppressed T1-weighted sequences.
“The reported sensitivity for diaphragmatic endometriosis by MRI is 78–83% when using fat-suppressed T1-weighted sequences [ 63 ].”
From Thoracic Endometriosis Syndrome: A Comprehensive Review and Multidisciplinary Approach to Management (2024) · cites this paper as [63]
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- Authors
- Rousset, P., Gregory, J., Rousset-Jablonski, C., Hugon-Rodin, J., Regnard, J.-F., Chapron, C., Coste, J., Golfier, F., & Revel, M.-P.
- Affiliations
- Lyon 1 Université (FR)
- Sorbonne Paris Cité (FR)
- Corresponding author
- Rousset, Pascal
- Venue
- European Radiology
- Published
- 2016-02-12
- Volume
- 26
- Issue
- 11
- Pages
- 3968-3977
- ISSN
- 0938-7994 (ISSN-L)
- 1432-1084
- OpenAlex
- W2281430586
- Cited by
- 64
- References
- 36
- Citations by year
- 2026: 6 · 2025: 12 · 2024: 11 · 2023: 4 · 2022: 5 · 2021: 8 · 2020: 6 · 2019: 5 · 2018: 4 · 2017: 3
- FWCI
- 5.32
- Type
- journal article
- Language
- en
- Open access
- closed
- Licence
- www.springer.com/tdm (tdm)
- Locations
- European Radiology (publishedVersion)
- PubMed (publishedVersion)
- Funders
- Systematics Association
- 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
- diaphragmatic endometriosis, MRI diagnosis, fat-suppressed T1-weighted imaging, micronodules, liver herniation, interobserver agreement, diagnostic sensitivity, surgical confirmation
- MeSH terms
- Adult, Diaphragm, Endometriosis, Female, Hernia, Diaphragmatic, Humans, Liver Diseases, Magnetic Resonance Imaging, Middle Aged, Muscular Diseases, Retrospective Studies, Young Adult, Patient Positioning
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