{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,7,30]],"date-time":"2025-07-30T15:05:13Z","timestamp":1753887913735,"version":"3.41.2"},"reference-count":25,"publisher":"FapUNIFESP (SciELO)","issue":"2","license":[{"start":{"date-parts":[[2025,1,1]],"date-time":"2025-01-01T00:00:00Z","timestamp":1735689600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2025,1,1]],"date-time":"2025-01-01T00:00:00Z","timestamp":1735689600000},"content-version":"am","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2025,1,1]],"date-time":"2025-01-01T00:00:00Z","timestamp":1735689600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Rev. Assoc. Med. Bras."],"abstract":"<jats:p>SUMMARY  OBJECTIVE: Deep pelvic endometriosis is the most common cause of chronic pelvic pain and infertility. Guidelines proposed standardized approaches for the diagnosis of deep pelvic endometriosis with ultrasonography and magnetic resonance imaging; however, knowing the reasons for discrepancy is crucial. We aimed to analyze the agreement between ultrasonography and magnetic resonance imaging for deep pelvic endometriosis findings and provide potential pitfalls and reasons for discordant findings.  METHODS: The study group consists of consecutive patients with deep pelvic endometriosis diagnosed on pelvic (n=1) or transvaginal ultrasonography (n=34) who underwent noncontrast pelvic magnetic resonance imaging. The agreement between the ultrasonography and magnetic resonance imaging was assessed using the prevalence and bias-adjusted kappa statistics. Potential pitfalls and reasons for discordant findings were presented.  RESULTS: The study group consisted of 35 patients with deep pelvic endometriosis. The mean age was 39.5\u00b16.2 years. The most common site of involvement was the rectosigmoid colon (n=34, 97.1%), followed by endometrioma\/hemorrhagic cyst (n=32, 91.4%). There was a perfect agreement for endometrioma\/hemorrhagic cyst (100%), almost perfect agreement for bladder involvement (PABAK=0.886), and moderate agreement for other sites. The number of uterosacral ligament involvement was lower with ultrasonography than with magnetic resonance imaging. However, due to the impact of gas signals on magnetic resonance imaging imaging, the number and boundaries of rectosigmoid deep pelvic endometriosis were better defined with ultrasonography.  CONCLUSION: The agreement between ultrasonography and magnetic resonance imaging for deep pelvic endometriosis findings varies according to the sites of involvement. Ultrasonography and magnetic resonance imaging are not standalone diagnostic techniques but are complementary to each other. We provided potential diagnostic pitfalls.<\/jats:p>","DOI":"10.1590\/1806-9282.20241235","type":"journal-article","created":{"date-parts":[[2025,4,2]],"date-time":"2025-04-02T08:42:55Z","timestamp":1743583375000},"source":"Crossref","is-referenced-by-count":0,"title":["Agreement between magnetic resonance imaging and ultrasonography in deep pelvic endometriosis"],"prefix":"10.1590","volume":"71","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0557-9552","authenticated-orcid":false,"given":"Mihriban","family":"Alkan","sequence":"first","affiliation":[{"name":"Ankara Bilkent City Hospital,  T\u00fcrkiye"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8208-8613","authenticated-orcid":false,"given":"G\u00fcls\u00fcm","family":"K\u0131l\u0131\u00e7kap","sequence":"additional","affiliation":[{"name":"Ankara Bilkent City Hospital,  T\u00fcrkiye"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"530","published-online":{"date-parts":[[2025]]},"reference":[{"issue":"24","key":"ref1","doi-asserted-by":"crossref","first-page":"1759","DOI":"10.1056\/NEJM199306173282407","article-title":"Endometriosis","volume":"328","author":"Olive DL","year":"1993","journal-title":"N Engl J Med"},{"issue":"6","key":"ref2","doi-asserted-by":"crossref","DOI":"10.1590\/1806-9282.706EDIT","article-title":"The challenges of female chronic pelvic pain","volume":"70","author":"Gibran L","year":"2024","journal-title":"Rev Assoc Med Bras (1992)"},{"key":"ref3","doi-asserted-by":"crossref","first-page":"100514","DOI":"10.1016\/j.clinsp.2024.100514","article-title":"Pelvic congestion syndrome as a differential diagnosis of chronic pelvic pain in women","volume":"79","author":"Messina ML","year":"2024","journal-title":"Clinics (Sao Paulo)"},{"issue":"3","key":"ref4","doi-asserted-by":"crossref","first-page":"611","DOI":"10.1007\/s00404-014-3470-7","article-title":"Accuracy of magnetic resonance in deeply infiltrating endometriosis: a systematic review and meta-analysis","volume":"291","author":"Medeiros LR","year":"2015","journal-title":"Arch Gynecol Obstet"},{"issue":"11","key":"ref5","doi-asserted-by":"crossref","first-page":"747","DOI":"10.1016\/j.diii.2020.04.015","article-title":"Added value of MRI for the diagnosis of adnexal torsion in children and adolescents after inconclusive ultrasound examination","volume":"101","author":"Rougier E","year":"2020","journal-title":"Diagn Interv Imaging"},{"issue":"3","key":"ref6","doi-asserted-by":"crossref","first-page":"318","DOI":"10.1002\/uog.15955","article-title":"Systematic approach to sonographic evaluation of the pelvis in women with suspected endometriosis, including terms, definitions and measurements: a consensus opinion from the International Deep Endometriosis Analysis (IDEA) group","volume":"48","author":"Guerriero S","year":"2016","journal-title":"Ultrasound Obstet Gynecol"},{"issue":"7","key":"ref7","doi-asserted-by":"crossref","first-page":"2765","DOI":"10.1007\/s00330-016-4673-z","article-title":"European society of urogenital radiology (ESUR) guidelines: MR imaging of pelvic endometriosis","volume":"27","author":"Bazot M","year":"2017","journal-title":"Eur Radiol"},{"issue":"4","key":"ref8","article-title":"An international terminology for endometriosis, 2021","volume":"2021","author":"Tomassetti C","year":"2021","journal-title":"Hum Reprod Open"},{"issue":"6","key":"ref9","doi-asserted-by":"crossref","first-page":"1608","DOI":"10.1007\/s00261-019-02182-1","article-title":"Systematic interpretation and structured reporting for pelvic magnetic resonance imaging studies in patients with endometriosis: value added for improved patient care","volume":"45","author":"Feldman MK","year":"2020","journal-title":"Abdom Radiol (NY)"},{"key":"ref10","first-page":"3208","article-title":"Comparison of physical examination, ultrasound techniques and magnetic resonance imaging for the diagnosis of deep infiltrating endometriosis: a systematic review and meta-analysis of diagnostic accuracy studies","volume":"20","author":"Zhang X","year":"2020","journal-title":"Exp Ther Med"},{"key":"ref11","doi-asserted-by":"crossref","first-page":"3583989","DOI":"10.1155\/2020\/3583989","article-title":"Diagnostic accuracy of ultrasound and MRI in the mapping of deep pelvic endometriosis using the International Deep Endometriosis Analysis (IDEA) Consensus","volume":"2020","author":"Indrielle-Kelly T","year":"2020","journal-title":"BioMed Res Int"},{"issue":"6","key":"ref12","doi-asserted-by":"crossref","first-page":"1829","DOI":"10.1007\/s00261-020-02417-6","article-title":"MRI impacts endometriosis management in the setting of image-based multidisciplinary conference: a retrospective analysis","volume":"45","author":"Burkett BJ","year":"2020","journal-title":"Abdom Radiol (NY)"},{"issue":"11","key":"ref13","doi-asserted-by":"crossref","first-page":"747","DOI":"10.1016\/j.diii.2020.04.015","article-title":"Added value of MRI for the diagnosis of adnexal torsion in children and adolescents after inconclusive ultrasound examination","volume":"101","author":"Rougier E","year":"2020","journal-title":"Diagn Interv Imaging"},{"issue":"6","key":"ref14","doi-asserted-by":"crossref","first-page":"1670","DOI":"10.1007\/s00261-019-02124-x","article-title":"Comparison of routine pelvic US and MR imaging in patients with pathologically confirmed endometriosis","volume":"45","author":"Bartlett DJ","year":"2020","journal-title":"Abdom Radiol (NY)"},{"issue":"2","key":"ref15","doi-asserted-by":"crossref","first-page":"123","DOI":"10.1097\/RUQ.0000000000000458","article-title":"The complementary role of ultrasound and magnetic resonance imaging in the evaluation of endometriosis: a review","volume":"36","author":"Craig EV","year":"2020","journal-title":"Ultrasound Q"},{"key":"ref16","doi-asserted-by":"crossref","first-page":"36","DOI":"10.1016\/j.ejogrb.2018.09.001","article-title":"Anatomic distribution of endometriosis: a reappraisal based on series of 1101 patients","volume":"230","author":"Audebert A","year":"2018","journal-title":"Eur J Obstet Gynecol Reprod Biol"},{"issue":"8","key":"ref17","doi-asserted-by":"crossref","first-page":"1686","DOI":"10.1093\/humrep\/deg314","article-title":"Transvaginal sonography and rectal endoscopic sonography for the assessment of pelvic endometriosis: a preliminary comparison","volume":"18","author":"Bazot M","year":"2003","journal-title":"Hum Reprod"},{"issue":"5","key":"ref18","doi-asserted-by":"crossref","first-page":"534","DOI":"10.1002\/uog.15667","article-title":"Accuracy of transvaginal ultrasound for diagnosis of deep endometriosis in uterosacral ligaments, rectovaginal septum, vagina and bladder: systematic review and meta-analysis","volume":"46","author":"Guerriero S","year":"2015","journal-title":"Ultrasound Obstet Gynecol"},{"issue":"2","key":"ref19","first-page":"CD009591","article-title":"Imaging modalities for the non-invasive diagnosis of endometriosis","volume":"2","author":"Nisenblat V","year":"2016","journal-title":"Cochrane Database Syst Rev"},{"key":"ref20","series-title":"Imagerie de la femme Gynecologie","volume-title":"Endometriose","author":"Bazot M","year":"2016"},{"issue":"5","key":"ref21","doi-asserted-by":"crossref","first-page":"586","DOI":"10.1002\/uog.18961","article-title":"Transvaginal ultrasound vs magnetic resonance imaging for diagnosing deep infiltrating endometriosis: systematic review and meta-analysis","volume":"51","author":"Guerriero S","year":"2018","journal-title":"Ultrasound Obstet Gynecol"},{"issue":"4","key":"ref22","doi-asserted-by":"crossref","first-page":"hoab041","DOI":"10.1093\/hropen\/hoab041","article-title":"Meta-analysis and systematic review to determine the optimal imaging modality for the detection of uterosacral ligaments\/torus uterinus, rectovaginal septum and vaginal deep endometriosis","volume":"2021","author":"Gerges B","year":"2021","journal-title":"Hum Reprod Open"},{"issue":"2","key":"ref23","doi-asserted-by":"crossref","first-page":"379","DOI":"10.1148\/radiol.2322030762","article-title":"Deep pelvic endometriosis: MR imaging for diagnosis and prediction of extension of disease","volume":"232","author":"Bazot M","year":"2004","journal-title":"Radiology"},{"issue":"7","key":"ref24","first-page":"CD012281","article-title":"Combination of the non-invasive tests for the diagnosis of endometriosis","volume":"7","author":"Nisenblat V","year":"2016","journal-title":"Cochrane Database Syst Rev"},{"issue":"2","key":"ref25","doi-asserted-by":"crossref","first-page":"366","DOI":"10.1016\/j.fertnstert.2015.05.002","article-title":"Ultrasound techniques in the diagnosis of deep pelvic endometriosis: algorithm based on a systematic review and meta-analysis","volume":"104","author":"Noventa M","year":"2015","journal-title":"Fertil Steril"}],"container-title":["Revista da Associa\u00e7\u00e3o M\u00e9dica Brasileira"],"original-title":[],"link":[{"URL":"http:\/\/www.scielo.br\/scielo.php?script=sci_pdf&pid=S0104-42302025000200612&tlng=en","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,4,2]],"date-time":"2025-04-02T08:44:03Z","timestamp":1743583443000},"score":1,"resource":{"primary":{"URL":"http:\/\/www.scielo.br\/scielo.php?script=sci_arttext&pid=S0104-42302025000200612&tlng=en"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025]]},"references-count":25,"journal-issue":{"issue":"2","published-online":{"date-parts":[[2025]]}},"alternative-id":["S0104-42302025000200612"],"URL":"https:\/\/doi.org\/10.1590\/1806-9282.20241235","relation":{},"ISSN":["1806-9282","0104-4230"],"issn-type":[{"type":"electronic","value":"1806-9282"},{"type":"print","value":"0104-4230"}],"subject":[],"published":{"date-parts":[[2025]]},"article-number":"e20241235"}}