Endometriosis MR mimickers: T2-hypointense lesions

被引:2
作者
Ruaux, Edouard [1 ]
VanBuren, Wendaline M. [2 ]
Nougaret, Stephanie [3 ]
Gavrel, Marie [1 ]
Charlot, Mathilde [1 ]
Grangeon, Flavia [1 ]
Bolze, Pierre-Adrien [4 ]
Thomassin-Naggara, Isabelle [5 ]
Rousset, Pascal [1 ]
机构
[1] Lyon 1 Claude Bernard Univ, Lyon Claude Bernard Univ 1, Dept Radiol, Hosp Civils Lyon,EMR 3738, Pierre Benite, France
[2] Dept Radiol, Mayo Clin, Rochester, MN 55905 USA
[3] Montpellier Univ, Montpellier Canc Inst, Dept Radiol, U1194, F-34295 Montpellier, France
[4] Lyon 1 Claude Bernard Univ, Lyon Claude Bernard Univ 1, Dept Gynecol & Obstet, Hosp Civils Lyon,EMR 3738, F-69495 Pierre Benite, France
[5] Sorbonne Univ, Hop Tenon, AP HP, Serv Imageries Radiol & Intervent Specialisees,Dep, F-75020 Paris, France
基金
欧洲研究理事会;
关键词
Endometriosis; Deep infiltrating endometriosis; Pelvic inflammatory disease; Genital diseases; Magnetic resonance imaging; MAGNETIC-RESONANCE; INFILTRATING ENDOMETRIOSIS; DEEP; FEATURES; WOMEN;
D O I
10.1186/s13244-023-01588-2
中图分类号
R8 [特种医学]; R445 [影像诊断学];
学科分类号
1002 ; 100207 ; 1009 ;
摘要
Endometriosis is a common crippling disease in women of reproductive age. Magnetic resonance imaging (MRI) is considered the cornerstone radiological technique for both the diagnosis and management of endometriosis. While its sensitivity, especially in deep infiltrating endometriosis, is superior to that of ultrasonography, many sources of false-positive results exist, leading to a lack of specificity. Hypointense lesions or pseudo-lesions on T2-weighted images include anatomical variants, fibrous connective tissues, benign and malignant tumors, feces, surgical materials, and post treatment scars which may mimic deep pelvic infiltrating endometriosis. False positives can have a major impact on patient management, from diagnosis to medical or surgical treatment. This educational review aims to help the radiologist acknowledge MRI criteria, pitfalls, and the differential diagnosis of deep pelvic infiltrating endometriosis to reduce false-positive results.Critical relevance statementMRI in deep infiltrating endometriosis has a 23% false-positive rate, leading to misdiagnosis. T2-hypointense lesions primarily result from anatomical variations, fibrous connective tissue, benign and malignant tumors, feces, surgical material, and post-treatment scars.Key points center dot MRI in DIE has a 23% false-positive rate, leading to potential misdiagnosis.center dot Anatomical variations, fibrous connective tissues, neoplasms, and surgical alterations are the main sources of T2-hypointense mimickers.center dot Multisequence interpretation, morphologic assessment, and precise anatomic localization are crucial to prevent overdiagnosis.center dot Gadolinium injection is beneficial for assessing endometriosis differential diagnosis only in specific conditions.
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页数:15
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