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Ruaux E, Nougaret S, Gavrel M, Charlot M, Devouassoux-Shisheboran M, Golfier F, Thomassin-Naggara I, Rousset P. Endometriosis MR mimickers: T1-hyperintense lesions. Insights Imaging 2024; 15:19. [PMID: 38267748 PMCID: PMC10808095 DOI: 10.1186/s13244-023-01587-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2023] [Accepted: 11/25/2023] [Indexed: 01/26/2024] Open
Abstract
Endometriosis is a chronic and disabling gynecological disease that affects women of reproductive age. Magnetic resonance imaging (MRI) is considered the cornerstone radiological technique for both the diagnosis and management of endometriosis. While MRI offers higher sensitivity compared to ultrasonography, it is prone to false-positive results, leading to decreased specificity. False-positive findings can arise from various T1-hyperintense conditions on fat-suppressed T1-weighted images, resembling endometriotic cystic lesions in different anatomical compartments. These conditions include hemorrhage, hyperproteic content, MRI artifacts, feces, or melanin. Such false positives can have significant implications for patient care, ranging from incorrect diagnoses to unnecessary medical or surgical interventions and subsequent follow-up. To address these challenges, this educational review aims to provide radiologists with comprehensive knowledge about MRI criteria, potential pitfalls, and differential diagnoses, ultimately reducing false-positive results related to T1-hyperintense abnormalities.Critical relevance statementMRI has a 10% false-positive rate, leading to misdiagnosis. T1-hyperintense lesions, observed in the three phenotypes of pelvic endometriosis, can also be seen in various other causes, mainly caused by hemorrhages, high protein concentrations, and artifacts.Key points• MRI in endometriosis has a 10% false-positive rate, leading to potential misdiagnosis.• Pelvic endometriosis lesions can exhibit T1-hyperintensity across their three phenotypes.• A definitive diagnosis of a T1-hyperintense endometriotic lesion is crucial for patient management.• Hemorrhages, high protein concentrations, lipids, and artifacts are the main sources of T1-hyperintense mimickers.
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Affiliation(s)
- Edouard Ruaux
- Department of Radiology, Hospices Civils de Lyon, Lyon Sud University Hospital, Lyon 1 Claude Bernard University, 165 Chemin du Grand Revoyet, EMR 3738, 69495, Pierre Bénite, France
| | - Stéphanie Nougaret
- Department of Radiology, Montpellier Cancer Institute, U1194, Montpellier University, 34295, Montpellier, France
| | - Marie Gavrel
- Department of Radiology, Hospices Civils de Lyon, Lyon Sud University Hospital, Lyon 1 Claude Bernard University, EMR 3738, Pierre Bénite, France
| | - Mathilde Charlot
- Department of Radiology, Hospices Civils de Lyon, Lyon Sud University Hospital, Lyon 1 Claude Bernard University, EMR 3738, Pierre Bénite, France
| | - Mojgan Devouassoux-Shisheboran
- Department of Pathology, Hospices Civils de Lyon, Lyon Sud University Hospital, Lyon 1 Claude Bernard University, 69495, Pierre Bénite, France
| | - François Golfier
- Department of Gynecology and Obstetrics, Hospices Civils de Lyon, Lyon Sud University Hospital, Lyon 1 Claude Bernard University, EMR 3738, 69495, Pierre Bénite, France
| | - Isabelle Thomassin-Naggara
- Department of Radiology, Service Imageries Radiologiques et Interventionnelles Spécialisées, Hôpital Tenon, Assistance Publique Hôpitaux de Paris, Sorbonne Université, 75020, Paris, France
| | - Pascal Rousset
- Department of Radiology, Hospices Civils de Lyon, Lyon Sud University Hospital, Lyon 1 Claude Bernard University, 165 Chemin du Grand Revoyet, EMR 3738, 69495, Pierre Bénite, France.
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Bilkhu AS, Wild J, Sagar PM. Management of retrorectal tumours. Br J Surg 2024; 111:znae012. [PMID: 38291005 DOI: 10.1093/bjs/znae012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2023] [Revised: 01/06/2024] [Accepted: 01/10/2024] [Indexed: 02/01/2024]
Affiliation(s)
- Amarvir S Bilkhu
- Colorectal & Peritoneal Oncology, The Christie Foundation NHS Trust, Manchester, UK
| | - Jonathan Wild
- Colorectal & Peritoneal Oncology, The Christie Foundation NHS Trust, Manchester, UK
| | - Peter M Sagar
- John Goligher Unit, Leeds Teaching Hospitals NHS Trust, Leeds, UK
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Sandonà D, Grossi U, Vittadello F, Frasson A, Sarzo G, Zucchella M, Mammano E, Passuello N. Laparoscopic resection of a retrorectal cystic tumor. Tech Coloproctol 2023; 27:1405-1406. [PMID: 37131115 DOI: 10.1007/s10151-023-02806-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/08/2023] [Accepted: 04/12/2023] [Indexed: 05/04/2023]
Affiliation(s)
- D Sandonà
- Department of Surgery, Hospital Sant' Antonio, University of Padua, Padua, Italy
| | - U Grossi
- Surgery Unit 2, Regional Hospital Treviso, Piazzale dell'Ospedale 1, 31100, Treviso, Italy.
- Department of Surgery, Oncology and Gastroenterology-DISCOG, University of Padua, Padua, Italy.
| | - F Vittadello
- Department of Surgery, Hospital Sant' Antonio, University of Padua, Padua, Italy
| | - A Frasson
- Department of Surgery, Hospital Sant' Antonio, University of Padua, Padua, Italy
| | - G Sarzo
- Department of Surgery, Hospital Sant' Antonio, University of Padua, Padua, Italy
| | - M Zucchella
- Surgery Unit 2, Regional Hospital Treviso, Piazzale dell'Ospedale 1, 31100, Treviso, Italy
| | - E Mammano
- Department of Surgery, Hospital Sant' Antonio, University of Padua, Padua, Italy
| | - N Passuello
- Department of Surgery, Hospital Sant' Antonio, University of Padua, Padua, Italy
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