Magnetic resonance imaging

Abstract

Pelvic endometriosis affects around 10% of women of reproductive age. Bowel endometriosis is one of the most severe forms and is the most common site of extragenital endometriosis. In women with deep infiltrating endometriosis, bowel endometriosis affects between 12% and 37% of women. Diagnosis of the extension of deep pelvic endometriosis can be made by clinical examination and laparoscopic exploration. Recent advances in imaging techniques may replace the gold standard of diagnostic laparoscopy for some locations of deep endometriosis. MRI is recommended as a second-line technique in the preoperative workup of deep endometriosis (Grade A). The sensitivity and specificity of MR imaging (MRI) for the diagnosis of intestinal involvement are around 95% and 100%, respectively. MRI allows to diagnose location of bowel endometriosis involvement, number (unique, multifocal, and/or multicentric), size to help surgeon. MR enterography is widely used to explore small-bowel and ileocecal diseases and fusion imaging can help in difficult case.