Magnetic Resonance Imaging of Endometriosis: The Role of Advanced Techniques
Laura Alonzo, Roberto Cannella, Giuseppe Gullo, Giulia Piombo, Giuseppe Cicero, Alessandra López, Valentina Billone, Alessandra Andrisani, Gaspare Cucinella, Antonio Lo Casto, Giuseppe Lo Re
Abstract
Endometriosis is a chronic inflammatory disease that affects about 10% of women, and it is characterized by the presence of endometrial tissue outside the uterine cavity. Associated symptoms are dyspareunia, chronic pelvic pain, and infertility. The diagnosis of endometriosis can be challenging due to various clinical and imaging presentations. Laparoscopy is the gold standard for the diagnosis, but it is an invasive procedure. The literature has increasingly promoted a switch to less invasive imaging techniques, such as ultrasound and magnetic resonance imaging (MRI). The latter, also in relation to the latest technological advances, allows a comprehensive and accurate assessment of the pelvis and it can also identify sites of endometriosis that escape laparoscopic evaluation. Furthermore, MRI has been found to be more accurate than other imaging techniques in relation to its improved sensitivity and specificity in identifying disease sites, also due to the role of new emerging sequences. This article aims to review the current role of advanced MRI applications in the assessment of endometriosis.