Deep rectosigmoid endometriosis: “mushroom cap” sign on T2-weighted MR imaging

Jung‐Hwan Yoon, Jung Hwan Yoon, Dongil Choi, Kee‐Taek Jang, Kee-Taek Jang, Chan Kyo Kim, Heejung Kim, Soon Jin Lee, Ho-Kyung Chun, Woo Yong Lee, Seong Hyeon Yun
Abdominal imaging · 2010 · vol. 35(6) , pp. 726–731 · doi:10.1007/s00261-010-9643-3 · PMID:20820774 · W1995507637
article OA: closed CC0 ⤵ 64 in-corpus citations
Full text JSON View on OpenAlex View on PubMed View at publisher
⚙ AI-generated summary by claude@2026-06+body, 2026-06-08 ⓘ

This study evaluated the T2-weighted MRI "mushroom cap" sign, finding it characteristic of deep rectosigmoid endometriosis and absent in other submucosal tumors.

One-sentence paraphrase of the abstract; not a substitute for reading it. No clinical advice. How this works

Full text 4,251 characters · extracted from oa-doi-fallback · 6 sections · click to expand

Abstract

Purpose The purpose of this study is to evaluate the “mushroom cap” sign on T2-weighted MR imaging in patients with submucosal tumors in the rectosigmoid colon.

Methods

From January 2001 to August 2009, 12 patients with four different diseases presenting or mimicking submucosal tumors in the rectosigmoid colon underwent colonic resection. All patients with deep endometriosis (n = 6), gastrointestinal stromal tumor (n = 4), metastasis from ovary cancer (n = 1), and carcinoid tumor (n = 1) had either an MRI of the rectum or pelvis before surgery. We evaluated the MRI findings and compared them with the macroscopic and microscopic observations in the resected specimens.

Results

In all six cases of deep endometriosis, a characteristic “mushroom cap” shaped appearance was found on T2-weighted MR imaging. Heterogeneous low signal intensity of the hypertrophic muscularis propria, covered with high signal intensity of the mucosa and submucosa on T2-weighted MR images, looked like a “mushroom cap” with the pattern of intraluminal endophytic growth. In histological findings, deep endometriosis involved the submucosa (n = 4) or mucosa (n = 2). The “mushroom cap” sign was not present in any of the six other tumors.

Conclusion

The “mushroom cap” sign on T2-weighted MR imaging may be a characteristic sign for diagnosing deep rectosigmoid endometriosis. Similar content being viewed by others

References

Olive DL, Schwartz LB (1993) Endometriosis. N Engl J Med 328:1759–1769 Macafee CH, Greer HL (1960) Intestinal endometriosis. A report of 29 cases and a survey of the literature. J Obstet Gynaecol Br Emp 67:539–555 Koga K, Osuga Y, Yano T, et al. (2003) Characteristic images of deeply infiltrating rectosigmoid endometriosis on transvaginal and transrectal ultrasonography. Hum Reprod 18:1328–1333 Chapron C, Jacob S, Dubuisson JB, et al. (2001) Laparoscopically assisted vaginal management of deep endometriosis infiltrating the rectovaginal septum. Acta Obstet Gynecol Scand 80:349–354 Chapron C, Dubuisson JB (2001) Management of deep endometriosis. Ann N Y Acad Sci 943:276–280 Miller LS, Barbarevech C, Friedman LS (1994) Less frequent causes of lower gastrointestinal bleeding. Gastroenterol Clin North Am 23:21–52 Kelly P, McCluggage WG, Gardiner KR, Loughrey MB (2008) Intestinal endometriosis morphologically mimicking colonic adenocarcinoma. Histopathology 52:510–514 Cornillie FJ, Oosterlynck D, Lauweryns JM, Koninckx PR (1990) Deeply infiltrating pelvic endometriosis: histology and clinical significance. Fertil Steril 53:978–983 Koninckx PR, Meuleman C, Demeyere S, Lesaffre E, Cornillie FJ (1991) Suggestive evidence that pelvic endometriosis is a progressive disease, whereas deeply infiltrating endometriosis is associated with pelvic pain. Fertil Steril 55:759–765 Hottat N, Larrousse C, Anaf V, et al. (2009) Endometriosis: contribution of 3.0-T pelvic MR imaging in preoperative assessment—initial results. Radiology 253:126–134 Marcal L, Nothaft MA, Coelho F, Choi H (2010) Deep pelvic endometriosis: MR imaging. Abdom Imaging. doi:10.1007/s00261-010-9611-y Grasso RF, Di Giacomo V, Sedati P, Sizzi O, Florio G, Faiella E, Rossetti A, Del Vescovo R, Beomonte Zobel B (2009) Diagnosis of deep infiltrating endometriosis: accuracy of magnetic resonance imaging and transvaginal 3D ultrasonography. Abdom Imaging. doi:10.1007/s00261-009-9587-7 Yantiss RK, Clement PB, Young RH (2001) Endometriosis of the intestinal tract: a study of 44 cases of a disease that may cause diverse challenges in clinical and pathologic evaluation. Am J Surg Pathol 25:445–454 Bazot M, Darai E, Hourani R, et al. (2004) Deep pelvic endometriosis: MR imaging for diagnosis and prediction of extension of disease. Radiology 232:379–389

Acknowledgement

This study was supported by the Samsung Biomedical Research Institute grant, #SBRI C-A7-425. Author information Authors and Affiliations Corresponding author Rights and permissions About this article Cite this article Yoon, J.H., Choi, D., Jang, KT. et al. Deep rectosigmoid endometriosis: “mushroom cap” sign on T2-weighted MR imaging. Abdom Imaging 35, 726–731 (2010). https://doi.org/10.1007/s00261-010-9643-3 Published: Issue date: DOI: https://doi.org/10.1007/s00261-010-9643-3

Text is read by the "Ask this paper" AI Q&A widget below. Extraction quality varies by source — PMC NXML preserves structure cleanly, OA-HTML may include some navigation residue, and OA-PDF can have broken hyphenation. The publisher copy (via DOI) is the canonical version.

My notes (saved in your browser only)

⚙ Ask this paper AI returns verbatim quotes from the full text · source: oa-doi-fallback ⓘ

Answers must be backed by verbatim quotes from this paper's full text. Hallucinated quotes are dropped automatically; if no verbatim passage answers the question, we say so. How this works

Condition tags

mesh:D004715endometriosis

MeSH descriptors

Colon, Sigmoid Endometriosis Magnetic Resonance Imaging Rectum Adult Colon, Sigmoid Colon, Sigmoid Diagnosis, Differential Endometriosis Endometriosis Endometriosis Female Humans Magnetic Resonance Imaging Middle Aged Rectum Rectum

Citation neighborhood

Papers in the corpus that this work cites (lower rings, blue) and that cite this one (upper rings, green). Dot size scales with the paper's in-corpus citation count — bigger dot = more influential within the endo/adeno field. Click a dot to open that paper. [ expand to 2 hops ] — adds papers reached through this work's immediate citers/citees. Heavier; up to 60 extra dots.

References (15)

Cited by (50)

Source provenance

europepmc
last seen: 2026-06-04T01:30:01.192114+00:00
openalex
last seen: 2026-06-04T00:00:01.174412+00:00
pubmed
last seen: 2026-05-13T22:17:00.782903+00:00
License: CC0 · commercial use OK