title: MR diagnosis of diaphragmatic endometriosis.
abstract: OBJECTIVE
  To evaluate magnetic resonance imaging (MRI) for diaphragmatic endometriosis diagnosis.
  
  
  METHODS
  Over a 2-year period, all diaphragmatic MRI performed in the context of diaphragmatic endometriosis were reviewed. Axial and coronal fat-suppressed T1- and T2-weighted sequences were analyzed by two independent readers for the presence of nodules, plaque lesions, micronodule clustering, or focal liver herniation. MR abnormalities were correlated to surgical findings in women surgically treated. Interobserver agreement was assessed by κ statistics.
  
  
  RESULTS
  Twenty-three women with diaphragmatic endometriosis criteria comprised the population; 14 had surgical confirmation and nine had symptoms relief with hormonal treatment. MRI sensitivity was 83 % (19/23; 95 % confidence interval [CI]: 68, 98) for reader 1 and 78 % (18/23; 95 % CI: 61, 95) for reader 2. Kappa value was 0.86 (95 % CI: 0.47, 1.00). Readers 1 and 2 detected 35 and 36 lesions, respectively, all right-sided and agreed for 32 lesions on the type, location, and signal. Lesions were mostly nodules (23/32, 72 %), predominantly posterior (28/32, 87.5 %) and hyperintense on T1 (20/32, 63 %). MRI was negative for both readers in 2 surgically treated patients with small nodules or isolated diaphragmatic holes.
  
  
  CONCLUSIONS
  MRI allows diaphragmatic endometriosis diagnosis with 78 to 83 % sensitivity and excellent interobserver agreement.
  
  
  CONCLUSIONS
  • MRI allows the diagnosis of diaphragmatic endometriosis with up to 83 % sensitivity. • Diaphragmatic endometriosis lesions are better depicted on fat-suppressed T1-weighted sequences. • Diaphragmatic lesions, mostly hyperintense nodules, are right-sided and predominantly posterior. • MRI can help in timely diagnosis of diaphragmatic endometriosis.
authors: Lyon 1 Claude Bernard University, Villeurbanne, France. roussetpascal@gmail.com.|Radiology Department, Centre Hospitalier Lyon Sud, 165 Chemin du Grand Revoyet, 69495, Pierre Bénite, France. roussetpascal@gmail.com.
authors: Pascal
authors: P
authors: Rousset
authors: Paris Descartes University, Sorbonne Paris Cité, Paris, France.|Biostatistics and Epidemiology department, Groupe Hospitalier Cochin Hôtel-Dieu, 27 Rue du Faubourg Saint-Jacques, 75014, Paris, France.
authors: Jules
authors: J
authors: Gregory
authors: Obstetric and Gynecologic Department, Centre Hospitalier Lyon Sud, 165 Chemin du Grand Revoyet, 69495, Pierre Bénite, France.
authors: Christine
authors: C
authors: Rousset-Jablonski
authors: Paris Descartes University, Sorbonne Paris Cité, Paris, France.|Gynecology Endocrinology Department, Groupe Hospitalier Cochin Hôtel-Dieu, 27 Rue du Faubourg Saint-Jacques, 75014, Paris, France.
authors: Justine
authors: J
authors: Hugon-Rodin
authors: Paris Descartes University, Sorbonne Paris Cité, Paris, France.|Thoracic Surgery Department, Groupe Hospitalier Cochin Hôtel-Dieu, 27 Rue du Faubourg Saint-Jacques, 75014, Paris, France.
authors: Jean-François
authors: JF
authors: Regnard
authors: Paris Descartes University, Sorbonne Paris Cité, Paris, France.|Obstetric and Gynecologic Department, Groupe Hospitalier Cochin Hôtel-Dieu, 27 Rue du Faubourg Saint-Jacques, 75014, Paris, France.
authors: Charles
authors: C
authors: Chapron
authors: Paris Descartes University, Sorbonne Paris Cité, Paris, France.|Biostatistics and Epidemiology department, Groupe Hospitalier Cochin Hôtel-Dieu, 27 Rue du Faubourg Saint-Jacques, 75014, Paris, France.
authors: Joël
authors: J
authors: Coste
authors: Lyon 1 Claude Bernard University, Villeurbanne, France.|Obstetric and Gynecologic Department, Centre Hospitalier Lyon Sud, 165 Chemin du Grand Revoyet, 69495, Pierre Bénite, France.
authors: François
authors: F
authors: Golfier
authors: Paris Descartes University, Sorbonne Paris Cité, Paris, France.|Radiology Department, Groupe Hospitalier Cochin Hôtel-Dieu, 27 Rue du Faubourg Saint-Jacques, 75014, Paris, France.
authors: Marie-Pierre
authors: MP
authors: Revel
mesh_terms: D000328:Adult; D003964:Diaphragm; D004715:Endometriosis / Q000175:diagnosis*; D005260:Female; D006548:Hernia, Diaphragmatic / Q000473:pathology; D006801:Humans; D008107:Liver Diseases / Q000473:pathology; D008279:Magnetic Resonance Imaging / Q000379:methods; D008875:Middle Aged; D009135:Muscular Diseases / Q000175:diagnosis*; D056888:Patient Positioning; D012189:Retrospective Studies; D055815:Young Adult
keywords: Basithoracic pain; Catamenial pneumothorax; Diaphragm; Endometriosis; Magnetic resonance imaging