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Citation:
Abdeldjalil B, Gaillard F, Knipe H, Cloverleaf sign (deep endometriosis). Reference article, Radiopaedia.org (Accessed on 04 Oct 2024) https://doi.org/10.53347/rID-187075
The cloverleaf sign is an MRI sign of deep endometriosis described in one case series 1. It is detectable on T2W sequences in sagittal, coronal, and axial planes when at least three organs (uterus, ovaries, rectum, bowel loops, etc.) are brought closer by constrictive adhesions and detectable T2-weighted hypointense deep infiltrating endometriosis 1,2.
The cloverleaf sign in deep infiltrating endometriosis suggests that complex surgery is more likely, as it is associated with longer operation times, a greater risk of bowel resection, and blood loss 1,2.
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1. Härmä K, Binda A, Ith M 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(1):53-9. doi:10.1097/RLI.0000000000000612 - Pubmed
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2. M Jidal, S El Haddad, N Allali, L Chat. The Cloverleaf Sign in Deep Infiltrating Endometriosis. Clin Image Case Rep J. 2024; 6(2): 380
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