{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,16]],"date-time":"2026-08-16T19:26:03Z","timestamp":1786908363498,"version":"build-2736575974"},"reference-count":26,"publisher":"Oxford University Press (OUP)","issue":"1","license":[{"start":{"date-parts":[[2021,2,17]],"date-time":"2021-02-17T00:00:00Z","timestamp":1613520000000},"content-version":"vor","delay-in-days":47,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2021,1,16]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>STUDY QUESTION<\/jats:title><jats:p>Could the anogenital distance (AGD) as assessed by MRI (MRI-AGD) be a diagnostic tool for endometriosis?<\/jats:p><\/jats:sec><jats:sec><jats:title>SUMMARY ANSWER<\/jats:title><jats:p>A short MRI-AGD is a strong diagnostic marker of endometriosis.<\/jats:p><\/jats:sec><jats:sec><jats:title>WHAT IS KNOWN ALREADY<\/jats:title><jats:p>A short clinically assessed AGD (C-AGD) is associated with the presence of endometriosis.<\/jats:p><\/jats:sec><jats:sec><jats:title>STUDY DESIGN, SIZE, DURATION<\/jats:title><jats:p>This study is a re-analysis of previously published data from a case\u2013control study.<\/jats:p><\/jats:sec><jats:sec><jats:title>PARTICIPANTS\/MATERIALS, SETTING, METHODS<\/jats:title><jats:p>Women undergoing pelvic surgery from January 2018 to June 2019 and who had a preoperative pelvic MRI were included. C-AGD was measured at the beginning of the surgery by a different operator who was unaware of the endometriosis status. MRI-AGD was measured retrospectively by a senior radiologist who was blinded to the final diagnosis. Two measurements were made: from the posterior wall of the clitoris to the anterior edge of the anal canal (MRI-AGD-AC), and from the posterior wall of the vagina to the anterior edge of the anal canal (MRI-AGD-AF).<\/jats:p><\/jats:sec><jats:sec><jats:title>MAIN RESULTS AND THE ROLE OF CHANCE<\/jats:title><jats:p>The study compared MRI-AGD of 67 women with endometriosis to 31 without endometriosis (controls). Average MRI-AGD-AF measurements were 13.3\u2009mm (\u00b13.9) and 21.2\u2009mm (\u00b15.4) in the endometriosis and non-endometriosis groups, respectively (P\u2009&amp;lt;\u200910\u22125). Average MRI-AGD-AC measurements were 40.4\u2009mm (\u00b17.3) and 51.1\u2009mm (\u00b18.6) for the endometriosis and non-endometriosis groups, respectively (P\u2009&amp;lt;\u200910\u22125). There was no difference of MRI-AGD in women with and without endometrioma (P\u2009=\u20090.21), or digestive involvement (P\u2009=\u20090.26). Moreover, MRI-AGD values were independent of the revised score of the American Society of Reproductive Medicine and the Enzian score. The diagnosis of endometriosis was negatively associated with both the MRI-AGD-AF (\u03b2 = \u22127.79, 95% CI (\u22129.88; \u22125.71), P\u2009&amp;lt;\u20090.001) and MRI-AGD-AC (\u03b2 = \u22129.51\u2009mm, 95% CI (\u221212.7; 6.24), P\u2009&amp;lt;\u20090.001) in multivariable analysis. Age (\u03b2 = +0.31\u2009mm, 95% CI (0.09; 0.53), P\u2009=\u20090.006) and BMI (\u03b2 = +0.44\u2009mm, 95% CI (0.17; 0.72), P\u2009=\u20090.001) were positively associated with the MRI-AGD-AC measurements in multivariable analysis. MRI-AGD-AF had an AUC of 0.869 (95% CI (0.79; 0.95)) and outperformed C-AGD. Using an optimal cut-off of 20\u2009mm for MRI-AGD-AF, a sensitivity of 97.01% and a specificity of 70.97% were noted.<\/jats:p><\/jats:sec><jats:sec><jats:title>LIMITATIONS, REASONS FOR CAUTION<\/jats:title><jats:p>This was a retrospective analysis and no adolescents had been included.<\/jats:p><\/jats:sec><jats:sec><jats:title>WIDER IMPLICATIONS OF THE FINDINGS<\/jats:title><jats:p>This study is consistent with previous works associating a short C-AGD with endometriosis and the absence of correlation with the disease phenotype. MRI-AGD is more accurate than C-AGD in this setting and could be evaluated in the MRI examination of patients with suspected endometriosis.<\/jats:p><\/jats:sec><jats:sec><jats:title>STUDY FUNDING\/COMPETING INTEREST(S)<\/jats:title><jats:p>N\/A.<\/jats:p><\/jats:sec><jats:sec><jats:title>TRIAL REGISTRATION NUMBER<\/jats:title><jats:p>The protocol was approved by the \u2018Groupe Nantais d\u2019Ethique dans le Domaine de la Sant\u00e9\u2019 and registered under reference 02651077.<\/jats:p><\/jats:sec>","DOI":"10.1093\/hropen\/hoab003","type":"journal-article","created":{"date-parts":[[2021,2,4]],"date-time":"2021-02-04T06:53:14Z","timestamp":1612421594000},"source":"Crossref","is-referenced-by-count":15,"title":["A short anogenital distance on MRI is a marker of endometriosis"],"prefix":"10.1093","volume":"2021","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7826-6656","authenticated-orcid":false,"given":"A","family":"Crestani","sequence":"first","affiliation":[{"name":"Department 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