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Objective <p>To propose an update of ESUR endometriosis guidelines to reflect advances in MRI indications, reporting, and classifications.</p> Methods <p>The ESUR Research Committee appointed two chairs (I.T.N., L.M.) to supervise the development of the updated guidelines. Following literature research, a survey was delivered to 20 experts in gynecological imaging from 10 countries. Two rounds of surveys were conducted to obtain a consensus according to a Delphi process method. In this article, the results regarding MR indication, the use of standardized reports, and classifications are presented</p> Results <p>Magnetic resonance imaging (MRI) is recommended when transvaginal ultrasonography is inconclusive in diagnosing endometriosis or negative, in a symptomatic patient, before surgery or interventional procedure, or after surgical treatment if symptoms persist. ESUR panelists consider the roles of an MR classification: to improve communication between radiologist and surgeon (100%, 20/20) and between the radiologist and the patient (45%, 9/20), to predict operating time if surgery is planned (70%, 14/20), to predict the length of hospital stay after surgery (40%, 8/20), and to predict postoperative complications (70%, 14/20). ESUR panelists strongly agree that using an MR classification is useful (19/20, 95%), especially the radiological score, deep-pelvic endometriosis index (dPEI). Among the ESUR expert group, 9/20 experts (45%) used or agreed to use drawings in their report to improve communication with patients.</p> Conclusion <p>Standardized MR reporting is crucial and should include the use of MR classification. Drawings are considered an option, knowing that communication with the patient and surgeon is of paramount importance.</p> Key Points <p><Emphasis Type="BoldItalic">Question</Emphasis> <i>ESUR’s endometriosis guidelines were last published in 2017; an update is provided to reflect advances in MRI indications, reporting, and classifications.</i></p> <p><Emphasis Type="BoldItalic">Findings</Emphasis> <i>MRI is advised for inconclusive/negative transvaginal ultrasound in symptomatic patients, before surgery, or post-treatment if symptoms persist. A structured report enhances communication with surgeons and patients.</i></p> <p><Emphasis Type="BoldItalic">Clinical relevance</Emphasis> <i>A standardized report based on a compartmental analysis of the location of endometriotic nodules, with optional drawings, is essential for comprehensive mapping and optimal communication with both patient and surgeon.</i></p> Graphical Abstract <p></p>

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ESUR consensus MRI for endometriosis: indications, reporting, and classifications

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2025年5月27日

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  • Isabelle Thomassin-Naggara,
  • Miriam Dolciami,
  • Luciana P. Chamie,
  • Adalgisa Guerra,
  • Nishat Bharwani,
  • Susan Freeman,
  • Pascal Rousset,
  • Lucia Manganaro,
  • Adalgisa Guerra,
  • Giacomo Avesani,
  • Marc Bazot,
  • Teresa Margarida Cunha,
  • Paolo Niccolò Franco,
  • Sue Freeman,
  • Rosemarie Forstner,
  • Benedetta Gui,
  • Edith Kermarrec,
  • Stefania Rizzo,
  • Hilal Sahin,
  • Shiwa Mansournia,
  • Isabelle Thomassin-Naggara,
  • Laura Buñesch Villalba,
  • Ramona Woitek

摘要

Objective

To propose an update of ESUR endometriosis guidelines to reflect advances in MRI indications, reporting, and classifications.

Methods

The ESUR Research Committee appointed two chairs (I.T.N., L.M.) to supervise the development of the updated guidelines. Following literature research, a survey was delivered to 20 experts in gynecological imaging from 10 countries. Two rounds of surveys were conducted to obtain a consensus according to a Delphi process method. In this article, the results regarding MR indication, the use of standardized reports, and classifications are presented

Results

Magnetic resonance imaging (MRI) is recommended when transvaginal ultrasonography is inconclusive in diagnosing endometriosis or negative, in a symptomatic patient, before surgery or interventional procedure, or after surgical treatment if symptoms persist. ESUR panelists consider the roles of an MR classification: to improve communication between radiologist and surgeon (100%, 20/20) and between the radiologist and the patient (45%, 9/20), to predict operating time if surgery is planned (70%, 14/20), to predict the length of hospital stay after surgery (40%, 8/20), and to predict postoperative complications (70%, 14/20). ESUR panelists strongly agree that using an MR classification is useful (19/20, 95%), especially the radiological score, deep-pelvic endometriosis index (dPEI). Among the ESUR expert group, 9/20 experts (45%) used or agreed to use drawings in their report to improve communication with patients.

Conclusion

Standardized MR reporting is crucial and should include the use of MR classification. Drawings are considered an option, knowing that communication with the patient and surgeon is of paramount importance.

Key Points

Question ESUR’s endometriosis guidelines were last published in 2017; an update is provided to reflect advances in MRI indications, reporting, and classifications.

Findings MRI is advised for inconclusive/negative transvaginal ultrasound in symptomatic patients, before surgery, or post-treatment if symptoms persist. A structured report enhances communication with surgeons and patients.

Clinical relevance A standardized report based on a compartmental analysis of the location of endometriotic nodules, with optional drawings, is essential for comprehensive mapping and optimal communication with both patient and surgeon.

Graphical Abstract