Skip to main content
Key Specialties
Cardiology Diabetology Endocrinology Gastroenterology Geriatrics and Gerontology Gynecology and Obstetrics Hematology Infectious Disease Internal Medicine Nephrology Neurology Oncology Pediatrics Respiratory Medicine Rheumatology Surgery
Congress Coverage
2024 ACC Congress 2023 ESMO Congress 2023 EASD Congress 2023 ERS Congress 2023 ESC Congress
Clinical Collections
Advances in Alzheimer’s

Keynote webinar | Spotlight on medication adherence

LIVE: Thursday 27th June 2024, 18:00-19:30 (CEST)
Join our expert panel to discover why you need to understand the drivers of non-adherence in your patients, and how you can optimize medication adherence in your clinics to drastically improve patient outcomes.
ADVANCED SEARCH
Log in
Top
Japanese Journal of Radiology

Open Access 25-04-2024 | Endometriosis | Invited Review

Endometriosis, a common but enigmatic disease with many faces: current concept of pathophysiology, and diagnostic strategy

Authors: Mayumi Takeuchi, Kenji Matsuzaki, Masafumi Harada

Published in: Japanese Journal of Radiology

Login to get access

Abstract

Endometriosis is a benign, common, but controversial disease due to its enigmatic etiopathogenesis and biological behavior. Recent studies suggest multiple genetic, and environmental factors may affect its onset and development. Genomic analysis revealed the presence of cancer-associated gene mutations, which may reflect the neoplastic aspect of endometriosis. The management has changed dramatically with the development of fertility-preserving, minimally invasive therapies. Diagnostic strategies based on these recent basic and clinical findings are reviewed. With a focus on the presentation of clinical cases, we discuss the imaging manifestations of endometriomas, deep endometriosis, less common site and rare site endometriosis, various complications, endometriosis-associated tumor-like lesions, and malignant transformation, with pathophysiologic conditions.
Literature
1.
Zondervan KT, Becker CM, Missmer SA. Endometriosis. N Engl J Med. 2020;26(382):1244–56.CrossRef
2.
Shafrir AL, Farland LV, Shah DK, Harris HR, Kvaskoff M, Zondervan K, et al. Risk for and consequences of endometriosis: A critical epidemiologic review. Best Pract Res Clin Obstet Gynaecol. 2018;51:1–15.PubMedCrossRef
3.
Saunders PTK, Horne AW. Endometriosis: Etiology, pathobiology, and therapeutic prospects. Cell. 2021;27(184):2807–24.CrossRef
4.
Irving JA, Clement PB. Diseases of the peritoneum. In: Kurman RJ, editor. Blaustein’s pathology of the female genital tract. 7th ed. New York: Springer-Verlag; 2018. p. 771–840.
5.
Stewart CJR, Ayhan A, Fukunaga M, Huntsman DG (2020). Endometriosis and related conditions. In: WHO Classification of Tumours Editorial Board, ed. WHO classification of tumours female genital tumours, 5th ed. Lyon: IARC Library Cataloguing-in-Publication Data:169–74.
6.
Prescott J, Farland LV, Tobias DK, Gaskins AJ, Spiegelman D, Chavarro JE, et al. A prospective cohort study of endometriosis and subsequent risk of infertility. Hum Reprod. 2016;31:1475–82.PubMedPubMedCentralCrossRef
7.
Kvaskoff M, Mu F, Terry KL, Harris HR, Poole EM, Farland L, Missmer SA. Endometriosis: a high-risk population for major chronic diseases? Hum Reprod Update. 2015;21:500–16.PubMedPubMedCentralCrossRef
8.
Sampson JA. Metastatic or Embolic Endometriosis, due to the Menstrual Dissemination of Endometrial Tissue into the Venous Circulation. Am J Pathol. 1927;3(93–110):43.
9.
Sampson JA. Peritoneal endometriosis due to menstrual dissemination of endometrial tissue into the peritoneal cavity. Am J Obstet Gynecol. 1927;14:422–69.CrossRef
10.
Wiegand KC, Shah SP, Al-Agha OM, Zhao Y, Tse K, Zeng T, et al. ARID1A mutations in endometriosis associated ovarian carcinomas. N Engl J Med. 2010;363:1532–43.PubMedPubMedCentralCrossRef
11.
Vercellini P, Viganò P, Somigliana E, Fedele L. Endometriosis: pathogenesis and treatment. Nat Rev Endocrinol. 2014;10:261–75.PubMedCrossRef
12.
13.
Johnson NP, Hummelshoj L, Adamson GD, Keckstein J, Taylor HS, Abrao MS, et al. World Endometriosis Society consensus on the classification of endometriosis. Hum Reprod. 2017;32:315–24.PubMedCrossRef
14.
15.
Keckstein J, Saridogan E, Ulrich UA, Sillem M, Oppelt P, Schweppe KW, et al. The #Enzian classification: A comprehensive non-invasive and surgical description system for endometriosis. Acta Obstet Gynecol Scand. 2021;100:1165–75.PubMedCrossRef
16.
Di Paola V, Manfredi R, Castelli F, Negrelli R, Mehrabi S, Pozzi MR. Detection and localization of deep endometriosis by means of MRI and correlation with the ENZIAN score. Eur J Radiol. 2015;84:568–74.PubMedCrossRef
17.
Burla L, Scheiner D, Samartzis EP, Seidel S, Eberhard M, Fink D, et al. The ENZIAN score as a preoperative MRI-based classification instrument for deep infiltrating endometriosis. Arch Gynecol Obstet. 2019;300:109–16.PubMedCrossRef
18.
Thomassin-Naggara I, Lamrabet S, Crestani A, Bekhouche A, Wahab CA, Kermarrec E, et al. Magnetic resonance imaging classification of deep pelvic endometriosis: description and impact on surgical management. Hum Reprod. 2020;35:1589–600.PubMedCrossRef
19.
Nishimura K, Togashi K, Itoh K, Fujisawa I, Noma S, Kawamura Y, et al. Endometrial cysts of the ovary: MR imaging. Radiology. 1987;162:315–8.PubMedCrossRef
20.
Togashi K, Nishimura K, Kimura I, Tsuda Y, Yamashita K, Shibata T, et al. Endometrial cysts: diagnosis with MR imaging. Radiology. 1991;180:73–8.PubMedCrossRef
21.
Dias JL, Veloso Gomes F, Lucas R, Cunha TM. The shading sign: is it exclusive of endometriomas? Abdom Radiol. 2015;40:2566–72.
22.
23.
Corwin MT, Gerscovich EO, Lamba R, Wilson M, McGahan JP. Differentiation of ovarian endometriomas from hemorrhagic cysts at MR imaging: utility of the T2 dark spot sign. Radiology. 2014;271:126–32.PubMedCrossRef
24.
Takeuchi M, Matsuzaki K, Kubo H, Nishitani H. Magnetic resonance manifestations of endometrial cysts at 3 T compared with 1.5 T. J Comput Assist Tomogr. 2008;32:369–71.PubMedCrossRef
25.
Takeuchi M, Matsuzaki K, Nishitani H. Susceptibility-weighted MRI of endometrioma: preliminary results. AJR Am J Roentgenol. 2008;191:1366–70.PubMedCrossRef
26.
Bulut E, Peker M, Kupeli A, Danisan G, Bulut AC. The efficiency of susceptibility-weighted MRI in the differentiation of endometriomas from haemorrhagic ovarian cysts. Abdom Radiol. 2021;46:5337–43.CrossRef
27.
Cornillie FJ, Oosterlynck D, Lauweryns JM, Koninckx PR. Deeply infiltrating pelvic endometriosis: histology and clinical significance. Fertil Steril. 1990;53:978–83.PubMedCrossRef
28.
Koninckx PR, Martin DC. Deep endometriosis: a consequence of infiltration or retraction or possibly adenomyosis externa? Fertil Steril. 1992;58:924–8.PubMedCrossRef
29.
Jha P, Sakala M, Chamie LP, Feldman M, Hindman N, Huang C, et al. Endometriosis MRI lexicon: consensus statement from the society of abdominal radiology endometriosis disease-focused panel. Abdom Radiol. 2020;45:1552–68.CrossRef
30.
Chamié LP, Blasbalg R, Pereira RM, Warmbrand G, Serafini PC. Findings of pelvic endometriosis at transvaginal US, MR imaging, and laparoscopy. Radiographics. 2011;31:E77-100.PubMedCrossRef
31.
Bazot M, Daraï E. Diagnosis of deep endometriosis: clinical examination, ultrasonography, magnetic resonance imaging, and other techniques. Fertil Steril. 2017;108:886–94.PubMedCrossRef
32.
Bazot M, Gasner A, Lafont C, Ballester M, Daraï E. Deep pelvic endometriosis: limited additional diagnostic value of postcontrast in comparison with conventional MR images. Eur J Radiol. 2011;80:e331–9.PubMedCrossRef
33.
Coutinho A Jr, Bittencourt LK, Pires CE, Junqueira F, Lima CM, Coutinho E, et al. MR imaging in deep pelvic endometriosis: a pictorial essay. Radiographics. 2011;31:549–67.PubMedCrossRef
34.
Bazot M, Darai E, Hourani R, Thomassin I, Cortez A, Uzan S, et al. Deep pelvic endometriosis: MR imaging for diagnosis and prediction of extension of disease. Radiology. 2004;232:379–89.PubMedCrossRef
35.
Del Frate C, Girometti R, Pittino M, Del Frate G, Bazzocchi M, Zuiani C. Deep retroperitoneal pelvic endometriosis: MR imaging appearance with laparoscopic correlation. Radiographics. 2006;26:1705–18.PubMedCrossRef
36.
Cimsit C, Yoldemir T, Guclu M, Akpinar IN. Susceptibility-weighted magnetic resonance imaging for the evaluation of deep infiltrating endometriosis: preliminary results. Acta Radiol. 2016;57:878–85.PubMedCrossRef
37.
Kataoka ML, Togashi K, Yamaoka T, Koyama T, Ueda H, Kobayashi H, et al. Posterior cul-de-sac obliteration associated with endometriosis: MR imaging evaluation. Radiology. 2005;234:815–23.PubMedCrossRef
38.
Macario S, Chassang M, Novellas S, Baudin G, Delotte J, Toullalan O, et al. The value of pelvic MRI in the diagnosis of posterior cul-de-sac obliteration in cases of deep pelvic endometriosis. AJR Am J Roentgenol. 2012;199:1410–5.PubMedCrossRef
39.
Williams JC, Burnett TL, Jones T, Venkatesh SK, VanBuren WM. Association between kissing and retropositioned ovaries and severity of endometriosis: MR imaging evaluation. Abdom Radiol. 2020;45:1637–44.CrossRef
40.
Härmä K, Binda A, Ith M, Poellinger A, Siegenthaler F, Heverhagen J, et al. Cloverleaf Sign in Pelvic Magnetic Resonance Imaging for Deep Infiltrating Endometriosis: Association With Longer Operation Times, Greater Blood Loss, and Higher Rates of Bowel Resection. Invest Radiol. 2020;55:53–9.PubMedCrossRef
41.
Chamié LP, Ribeiro DMFR, Tiferes DA, Macedo Neto AC, Serafini PC. Atypical Sites of Deeply Infiltrative Endometriosis: Clinical Characteristics and Imaging Findings. Radiographics. 2018;38:309–28.PubMedCrossRef
42.
Gui B, Valentini AL, Ninivaggi V, Marino M, Iacobucci M, Bonomo L. Deep pelvic endometriosis: don’t forget round ligaments. Review of anatomy, clinical characteristics, and MR imaging features. Abdom Imaging. 2014;39:622–32.PubMedCrossRef
43.
Tokue H, Tsushima Y, Endo K. Magnetic resonance imaging findings of extrapelvic endometriosis of the round ligament. Jpn J Radiol. 2009;27:45–7.PubMedCrossRef
44.
Chapron C, Tosti C, Marcellin L, Bourdon M, Lafay-Pillet MC, Millischer AE, et al. Relationship between the magnetic resonance imaging appearance of adenomyosis and endometriosis phenotypes. Hum Reprod. 2017;32:1393–401.PubMedCrossRef
45.
Kishi Y, Suginami H, Kuramori R, Yabuta M, Suginami R, Taniguchi F. Four subtypes of adenomyosis assessed by magnetic resonance imaging and their specification. Am J Obstet Gynecol. 2012;207(114):e1-7.
46.
Takeuchi M, Matsuzaki K. Adenomyosis: usual and unusual imaging manifestations, pitfalls, and problem-solving MR imaging techniques. Radiographics. 2011;31:99–115.PubMedCrossRef
47.
Busard MP, Mijatovic V, Lüchinger AB, Bleeker MC, Pietersvan den Bos IC, Schats R, et al. MR imaging of bladder endometriosis and its relationship with the anterior uterine wall: experience in a tertiary referral centre. Eur J Radiol. 2012;81:2106–11.PubMedCrossRef
48.
Tian Z, Zhang YC, Sun XH, Wang Y, Zhao Y, Chang XH, et al. Accuracy of transvaginal ultrasound and magnetic resonance imaging for diagnosis of deep endometriosis in bladder and ureter: a meta-analysis. J Obstet Gynaecol. 2022;42:2272–81.PubMedCrossRef
49.
Takeuchi M, Matsuzaki K, Harada M. Susceptibility-weighted MRI of extra-ovarian endometriosis: preliminary results. Abdom Imaging. 2015;40:2512–6.PubMedCrossRef
50.
Busard MP, van der Houwen LE, Bleeker MC, Pieters van den Bos IC, Cuesta MA, van Kuijk C, et al. Deep infiltrating endometriosis of the bowel: MR imaging as a method to predict muscular invasion. Abdom Imaging. 2012;37:549–57.PubMedCrossRef
51.
Yoon JH, Choi D, Jang KT, Kim CK, Kim H, Lee SJ, et al. Deep rectosigmoid endometriosis: “mushroom cap” sign on T2-weighted MR imaging. Abdom Imaging. 2010;35:726–33.PubMedCrossRef
52.
Jaramillo-Cardoso A, Shenoy-Bhangle AS, VanBuren WM, Schiappacasse G, Menias CO, Mortele KJ. Imaging of gastrointestinal endometriosis: what the radiologist should know. Abdom Radiol. 2020;45:1694–710.CrossRef
53.
Li J, Liu Y, Du K, Xiao L, He X, Dai F, et al. Endometriosis in para-aortic lymph node resembling a malignancy: a case report and literature review. BMC Womens Health. 2022;22:101.PubMedPubMedCentralCrossRef
54.
Beavis AL, Matsuo K, Grubbs BH, Srivastava SA, Truong CM, Moffitt MN, et al. Endometriosis in para-aortic lymph nodes during pregnancy: case report and review of literature. Fertil Steril. 2011;95(2429):e9-13.
55.
Yarmish G, Sala E, Goldman DA, Lakhman Y, Soslow RA, Hricak H, et al. Abdominal wall endometriosis: differentiation from other masses using CT features. Abdom Radiol. 2017;42:1517–23.CrossRef
56.
Jaramillo-Cardoso A, Balcacer P, Garces-Descovich A, Beker K, Roth E, Glickman J, Mortele KJ. Multimodality imaging and clinicopathologic assessment of abdominal wall endometriosis: knocking down the enigma. Abdom Radiol. 2020;45:1800–12.CrossRef
57.
Busard MP, Mijatovic V, van Kuijk C, Hompes PG, van Waesberghe JH. Appearance of abdominal wall endometriosis on MR imaging. Eur Radiol. 2010;20:1267–76.PubMedCrossRef
58.
Solak A, Sahin N, Genç B, Sever AR, Genç M, Sivrikoz ON. Diagnostic value of susceptibility-weighted imaging of abdominal wall endometriomas during the cyclic menstrual changes: a preliminary study. Eur J Radiol. 2013;82:e411–6.PubMedCrossRef
59.
Rousset P, Gregory J, Rousset-Jablonski C, Hugon-Rodin J, Regnard JF, Chapron C, et al. MR diagnosis of diaphragmatic endometriosis. Eur Radiol. 2016;26:3968–77.PubMedCrossRef
60.
Gil Y, Tulandi T. Diagnosis and Treatment of Catamenial Pneumothorax: A Systematic Review. J Minim Invasive Gynecol. 2020;27:48–53.PubMedCrossRef
61.
Joseph J, Sahn SA. Thoracic endometriosis syndrome: new observations from an analysis of 110 cases. Am J Med. 1996;100:164–70.PubMedCrossRef
62.
Suzuki S, Yasumoto M, Matsumoto R, Andoh A. MR findings of ruptured endometrial cyst: comparison with tubo-ovarian abscess. Eur J Radiol. 2012;81:3631–7.PubMedCrossRef
63.
Iraha Y, Okada M, Iraha R, Azama K, Yamashiro T, Tsubakimoto M, et al. CT and MR Imaging of Gynecologic Emergencies. Radiographics. 2017;37:1569–86.PubMedCrossRef
64.
Chen MJ, Yang JH, Yang YS, Ho HN. Increased occurrence of tubo-ovarian abscesses in women with stage III and IV endometriosis. Fertil Steril. 2004;82:498–9.PubMedCrossRef
65.
Revzin MV, Mathur M, Dave HB, Macer ML, Spektor M. Pelvic Inflammatory Disease: Multimodality Imaging Approach with Clinical-Pathologic Correlation. Radiographics. 2016;36:1579–96.PubMedCrossRef
66.
67.
Robinson KA, Menias CO, Chen L, Schiappacasse G, Shaaban AM, Caserta MP, et al. Understanding malignant transformation of endometriosis: imaging features with pathologic correlation. Abdom Radiol. 2020;45:1762–75.CrossRef
68.
Sampson JA. Endometrial carcinoma of the ovary, arising in endometrial tissue in that organ. Arch Surg. 1925;10:1–72.CrossRef
69.
Scott RB. Malignant changes in endometriosis. Obstet Gynecol. 1953;2:283–9.PubMed
70.
Grandi G, Toss A, Cortesi L, Botticelli L, Volpe A, Cagnacci A. The Association between Endometriomas and Ovarian Cancer: Preventive Effect of Inhibiting Ovulation and Menstruation during Reproductive Life. Biomed Res Int. 2015;2015: 751571.PubMedPubMedCentralCrossRef
71.
Yamaguchi K, Mandai M, Toyokuni S, Hamanishi J, Higuchi T, Takakura K, et al. Contents of endometriotic cysts, especially the high concentration of free iron, are a possible cause of carcinogenesis in the cysts through the iron-induced persistent oxidative stress. Clin Cancer Res. 2008;14:32–40.PubMedCrossRef
72.
Wang C, Liang Z, Liu X, Zhang Q, Li S. The association between endometriosis, tubal ligation, hysterectomy and epithelial ovarian cancer: meta-analyses. Int J Environ Res Public Health. 2016;13:E1138.CrossRef
73.
74.
Higashiura Y, Kajihara H, Shigetomi H, Kobayashi H. Identification of multiple pathways involved in the malignant transformation of endometriosis (Review). Oncol Lett. 2012;4:3–9.PubMedPubMedCentralCrossRef
75.
76.
Tanaka YO, Yoshizako T, Nishida M, Yamaguchi M, Sugimura K, Itai Y. Ovarian carcinoma in patients with endometriosis: MR imaging findings. AJR Am J Roentgenol. 2000;175:1423–30.PubMedCrossRef
77.
Takeuchi M, Matsuzaki K, Uehara H, Nishitani H. Malignant transformation of pelvic endometriosis: MR imaging findings and pathologic correlation. Radiographics. 2006;26:407–17.PubMedCrossRef
78.
Tanaka YO, Okada S, Yagi T, Satoh T, Oki A, Tsunoda H, et al. MRI of endometriotic cysts in association with ovarian carcinoma. AJR Am J Roentgenol. 2010;194:355–61.PubMedCrossRef
79.
Takeuchi M, Matsuzaki K, Nishitani H. Diffusion-weighted magnetic resonance imaging of ovarian tumors: differentiation of benign and malignant solid components of ovarian masses. J Comput Assist Tomogr. 2010;34:173–6.PubMedCrossRef
80.
Nishio N, Kido A, Kataoka M, Kuwahara R, Nakao K, Kurata Y, et al. Longitudinal changes in magnetic resonance imaging of malignant and borderline tumors associated with ovarian endometriotic cyst comparing with endometriotic cysts without arising malignancy. Eur J Radiol. 2018;105:175–81.PubMedCrossRef
81.
McDermott S, Oei TN, Iyer VR, Lee SI. MR imaging of malignancies arising in endometriomas and extraovarian endometriosis. Radiographics. 2012;32:845–63.PubMedCrossRef
82.
Kataoka M, Togashi K, Koyama T, Yamaoka T, Iwasa Y, Fujii S, et al. MR imaging of müllerian mucinous borderline tumors arising from endometriotic cysts. J Comput Assist Tomogr. 2002;26:532–7.PubMedCrossRef
83.
Kurata Y, Kido A, Moribata Y, Kameyama K, Himoto Y, Minamiguchi S, et al. Diagnostic performance of MR imaging findings and quantitative values in the differentiation of seromucinous borderline tumour from endometriosis-related malignant ovarian tumour. Eur Radiol. 2017;27:1695–703.PubMedCrossRef
84.
Kurata Y, Kido A, Moribata Y, Kameyama K, Minamiguchi S, Konishi I, et al. Differentiation of Seromucinous Borderline Tumor from Serous Borderline Tumor on MR Imaging. Magn Reson Med Sci. 2018;17:211–7.PubMedCrossRef
85.
Arslanian E, Singh K, James Sung C, Quddus MR. Somatic mutation analysis of Mesonephric-Like adenocarcinoma and associated putative precursor Lesions: Insight into pathogenesis and potential molecular treatment targets. Gynecol Oncol Rep. 2022;42: 101049.PubMedPubMedCentralCrossRef
86.
Seay K, Akanbi T, Bustamante B, Chaudhary S, Goldberg GL. Mesonephric-like adenocarcinoma of the ovary with co-existent endometriosis: A case report and review of the literature. Gynecol Oncol Rep. 2020;34: 100657.PubMedPubMedCentralCrossRef
87.
Saida T, Mori K, Tanaka YO, Sakai M, Amano T, Kikuchi S, et al. Carcinosarcoma of the ovary: MR and clinical findings compared with high-grade serous carcinoma. Jpn J Radiol. 2021;39:357–66.PubMedCrossRef
88.
Shetty M, Lal N, Vu NH. Müllerian adenosarcoma of the ovary: case report and review of the literature. Ultrasound Q. 2007;23:189–91.PubMedCrossRef
89.
Sqalli Houssaini M, Haloua M, Mourabiti AY, Tahiri L, Fdili Alaoui FZ, et al. A case of ovarian endometrial stromal sarcoma: Radiological and histopathological findings. Radiol Case Rep. 2023;28(18):3529–34.CrossRef
90.
Yamamoto S, Tsuda H, Suzuki K, Takano M, Tamai S, Matsubara O. An allelotype analysis indicating the presence of two distinct ovarian clear-cell carcinogenic pathways: endometriosis-associated pathway vs. clear-cell adenofibroma-associated pathway. Virchows Arch. 2009;455:261–70.PubMedCrossRef
91.
Zhao C, Wu LS, Barner R. Pathogenesis of ovarian clear cell adenofibroma, atypical proliferative (borderline) tumor, and carcinoma: clinicopathologic features of tumors with endometriosis or adenofibromatous components support two related pathways of tumor development. J Cancer. 2011;2:94–106.PubMedPubMedCentralCrossRef
92.
Takeuchi M, Matsuzaki K, Uehara H, Furumoto H, Harada M. Clear cell adenocarcinoma arising from clear cell adenofibroma of the ovary: value of DWI and DCE-MRI. Magn Reson Med Sci. 2013;12:305–8.PubMedCrossRef
93.
Takeuchi M, Matsuzaki K, Nishitani H. Magnetic resonance manifestations of decidualized endometriomas during pregnancy. J Comput Assist Tomogr. 2008;32:353–5.PubMedCrossRef
94.
Morisawa N, Kido A, Kataoka M, Minamiguchi S, Konishi I, et al. Magnetic resonance imaging manifestations of decidualized endometriotic cysts: comparative study with ovarian cancers associated with endometriotic cysts. J Comput Assist Tomogr. 2014;38:879–84.PubMedCrossRef
95.
Takeuchi M, Matsuzaki K, Harada M. Computed diffusion-weighted imaging for differentiating decidualized endometrioma from ovarian cancer. Eur J Radiol. 2016;85:1016–9.PubMedCrossRef
96.
Ando T, Kato H, Kawaguchi M, Furui T, Morishige KI, Hyodo F, et al. MR findings for differentiating decidualized endometriomas from seromucinous borderline tumors of the ovary. Abdom Radiol. 2020;45:1783–9.CrossRef
97.
Parker RL, Dadmanesh F, Young RH, Clement PB. Polypoid endometriosis: a clinicopathologic analysis of 24 cases and a review of the literature. Am J Surg Pathol. 2004;28:285–97.PubMedCrossRef
98.
Takeuchi M, Matsuzaki K, Bando Y, Harada M. Magnetic resonance imaging characteristics of polypoid endometriosis and review of the literature. J Obstet Gynaecol Res. 2022;48:2583–93.PubMedCrossRef
99.
Takeuchi M, Matsuzaki K, Furumoto H, Nishitani H. Case report: A case of polypoid endometriosis: MR pathological correlation. Br J Radiol. 2008;81:e118–9.PubMedCrossRef
100.
Takeuchi M, Matsuzaki K, Bando Y, Nishimura M, Yoneda A, Harada M. A case of polypoid endometriosis with malignant transformation. Abdom Radiol. 2016;41:1699–702.CrossRef
Metadata
Title
Endometriosis, a common but enigmatic disease with many faces: current concept of pathophysiology, and diagnostic strategy
Authors
Mayumi Takeuchi
Kenji Matsuzaki
Masafumi Harada
Publication date
25-04-2024
Publisher
Springer Nature Singapore
Published in
Japanese Journal of Radiology
Print ISSN: 1867-1071
Electronic ISSN: 1867-108X
DOI
https://doi.org/10.1007/s11604-024-01569-5