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European Radiology

, Volume 27, Issue 7, pp 2765–2775

First Online: 05 December 2016Received: 03 June 2016Revised: 05 October 2016Accepted: 23 November 2016DOI: 10.1007-s00330-016-4673-z

Cite this article as: Bazot, M., Bharwani, N., Huchon, C. et al. Eur Radiol 2017 27: 2765. doi:10.1007-s00330-016-4673-z

AbstractEndometriosis is a common gynaecological condition of unknown aetiology that primarily affects women of reproductive age. The accepted first-line imaging modality is pelvic ultrasound. However, magnetic resonance imaging MRI is increasingly performed as an additional investigation in complex cases and for surgical planning. There is currently no international consensus regarding patient preparation, MRI protocols or reporting criteria. Our aim was to develop clinical guidelines for MRI evaluation of pelvic endometriosis based on literature evidence and consensus expert opinion. This work was performed by a group of radiologists from the European Society of Urogenital Radiology ESUR, experts in gynaecological imaging and a gynaecologist expert in methodology. The group discussed indications for MRI, technical requirements, patient preparation, MRI protocols and criteria for the diagnosis of pelvic endometriosis on MRI. The expert panel proposed a final recommendation for each criterion using Oxford Centre for Evidence Based Medicine OCEBM 2011 levels of evidence.

Key Points• This report provides guidelines for MRI in endometriosis.

• Minimal and optimal MRI acquisition protocols are provided.

• Recommendations are proposed for patient preparation, best MRI sequences and reporting criteria.

KeywordsEndometriosis Guidelines Magnetic resonance imaging MRI Protocols Evidence-based Medicine-standards Abbreviations2DTwo-dimensional


DPEDeep pelvic endometriosis

DWIDiffusion-weighted imaging

ESUREuropean Society of Urogenital Radiology

FPI-ESURFemale Pelvic Imaging working group of the European Society of Urogenital Radiology

GPPGood practice point

HASTEHalf-Fourier acquisition single shot turbo-spin-echo



LELevel of evidence

MRIMagnetic resonance imaging

OCEBMOxford Centre for Evidence Based Medicine


SNRSignal-to-noise ratio

SWISusceptibility-weighted imaging




TVSTransvaginal sonography


Electronic supplementary materialThe online version of this article doi:10.1007-s00330-016-4673-z contains supplementary material, which is available to authorized users.

Autor: M. Bazot - N. Bharwani - C. Huchon - K. Kinkel - T. M. Cunha - A. Guerra - L. Manganaro - L. Buñesch - A. Kido - K. To


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