{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,11,12]],"date-time":"2025-11-12T14:23:49Z","timestamp":1762957429654,"version":"3.37.3"},"reference-count":42,"publisher":"Oxford University Press (OUP)","issue":"1157","license":[{"start":{"date-parts":[[2024,4,5]],"date-time":"2024-04-05T00:00:00Z","timestamp":1712275200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2024,5,7]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Objective<\/jats:title>\n                  <jats:p>This study aimed to establish the first-ever MRI classification of uterosacral ligament (USL) involvement in deep infiltrating endometriosis (DIE), based on reliable preoperative MRI features correlated with positive predictive values (PPVs) determined through histopathological analysis.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>Twenty-two women underwent surgery with histopathology due to symptoms highly suggestive of endometriosis. The 22 preoperative MRIs were analysed retrospectively, blinded to histopathology, and a classification of the preoperative aspect of USLs linked to PPVs was designed.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>According to their aspects, 6 radiological types of USL were identified. The \u201cL-category\u201d corresponded to linear types with regular or irregular margins, including types 1, 2, 3A, and 3B. The \u201cN-category\u201d corresponded to haemorrhagic or nodular types, including types 4, 5A, 5B, and 6. For the L-category, PPVs ranged from 75% to 88%, depending on the USL radiological type. For the N-category, PPVs were 100% for each type. In women with endometriosis symptoms, MRI underestimated USL involvement, especially for type 1. Among the 6 uteri with lateral deviation, only one false-positive result concerning the stretched USL was induced.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>In women with endometriosis symptoms, our MRI classification identified 2 USL categories, corresponding to 2 kinds of PPV; in these symptomatic patients, a normal MRI does not rule out a DIE diagnosis.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Advances in knowledge<\/jats:title>\n                  <jats:p>Our MRI classification of USL involvement in endometriosis may be used as a non-invasive staging of the disease, making it much clearer for clinicians and patients. Hence, we are able to propose a suitable diagnostic and therapeutic procedure for each radiological type.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/bjr\/tqae072","type":"journal-article","created":{"date-parts":[[2024,4,5]],"date-time":"2024-04-05T20:22:41Z","timestamp":1712348561000},"page":"993-1002","source":"Crossref","is-referenced-by-count":3,"title":["MRI classification of uterosacral ligament involvement in endometriosis: the H\u00f4tel-Dieu classification"],"prefix":"10.1093","volume":"97","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9876-2633","authenticated-orcid":false,"given":"Siegfried","family":"H\u00e9lage","sequence":"first","affiliation":[{"name":"Department of Radiology, H\u00f4tel-Dieu de Paris (AP-HP) , Paris 75004, France"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lucas","family":"Rivi\u00e8re","sequence":"additional","affiliation":[{"name":"Department of Radiology, H\u00f4tel-Dieu de Paris (AP-HP) , Paris 75004, France"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jean-No\u00ebl","family":"Buy","sequence":"additional","affiliation":[{"name":"Department of Radiology, H\u00f4tel-Dieu de Paris (AP-HP) , Paris 75004, France"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Corinne","family":"Bordonn\u00e9","sequence":"additional","affiliation":[{"name":"Department of Radiology, H\u00f4tel-Dieu de Paris (AP-HP) , Paris 75004, France"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Fr\u00e9d\u00e9ric","family":"Pr\u00e9aux","sequence":"additional","affiliation":[{"name":"L\u00e9onard de Vinci Medical Imaging, 43 rue Cortambert , Paris 75016, France"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Pierre-Alexandre","family":"Just","sequence":"additional","affiliation":[{"name":"Department of Pathology, H\u00f4pital Cochin (AP-HP) , Paris 75014, France"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nizar","family":"Aflak","sequence":"additional","affiliation":[{"name":"Department of Gynecological Surgery, H\u00f4pital Beaujon (AP-HP) , Clichy 92110, France"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Pascal","family":"Rousset","sequence":"additional","affiliation":[{"name":"Department of Radiology, Centre Hospitalier Lyon Sud , Hospices Civils de Lyon, Pierre B\u00e9nite 69495, France"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"\u00c9lisabeth","family":"Dion","sequence":"additional","affiliation":[{"name":"Department of Radiology, H\u00f4tel-Dieu de Paris (AP-HP) , Paris 75004, France"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"286","published-online":{"date-parts":[[2024,4,5]]},"reference":[{"issue":"25","key":"2024051411372318600_tqae072-B1","doi-asserted-by":"crossref","first-page":"2389","DOI":"10.1056\/NEJMcp1000274","article-title":"Clinical practice. 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