Thomassin-Naggara Isabelle, Dolciami Miriam, Chamie Luciana P, Guerra Adalgisa, Bharwani Nishat, Freeman Susan, Rousset Pascal, Manganaro Lucia
Imageries Radiologiques et Interventionnelles Spécialisées (IRIS), APHP Sorbonne Université Hopital Tenon, Paris, France.
Sorbonne Université, GRC Endometriose, GRC6-C3E, Paris, France.
Eur Radiol. 2025 May 27. doi: 10.1007/s00330-025-11579-0.
To propose an update of ESUR endometriosis guidelines to reflect advances in MRI indications, reporting, and classifications.
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.
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.
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.
对欧洲泌尿生殖放射学会（ESUR）子宫内膜异位症指南进行更新，以反映磁共振成像（MRI）在适应证、报告及分类方面的进展。
ESUR研究委员会任命两位主席（I.T.N.、L.M.）监督更新指南的制定。在文献研究之后，向来自10个国家的20位妇科影像专家进行了一项调查。根据德尔菲法进行了两轮调查以达成共识。本文展示了关于MRI适应证、标准化报告的使用及分类的结果。
对于有症状的患者，当经阴道超声检查在诊断子宫内膜异位症时结果不明确或为阴性，在手术或介入操作前，或手术治疗后症状仍持续时，推荐使用磁共振成像（MRI）。ESUR小组成员认为MRI分类有以下作用：改善放射科医生与外科医生之间的沟通（100%，20/20）以及放射科医生与患者之间的沟通（45%，9/20），如果计划进行手术则预测手术时间（70%，14/20），预测手术后住院时间（40%，8/20），以及预测术后并发症（70%，14/20）。ESUR小组成员强烈认同使用MRI分类是有用的（19/20，95%），尤其是放射学评分、深部盆腔子宫内膜异位症指数（dPEI）。在ESUR专家组中，9/20位专家（45%）在其报告中使用或同意使用图表以改善与患者的沟通。
标准化的MRI报告至关重要，应包括MRI分类的使用。鉴于与患者和外科医生的沟通至关重要，图表被视为一种选择。
问题ESUR的子宫内膜异位症指南上次于2017年发布；现提供更新以反映MRI适应证、报告及分类方面的进展。
发现对于有症状的患者，若经阴道超声检查结果不明确/为阴性，在手术前，或治疗后症状仍持续时，建议使用MRI。结构化报告可加强与外科医生和患者的沟通。
临床意义基于对子宫内膜异位结节位置进行分区分析的标准化报告，并可选择使用图表，对于全面描绘病情以及与患者和外科医生进行最佳沟通至关重要。
