ENDOMETRIOSIS, What Radiologists Should Know

Congress:

ECR 2013

Poster Number:

C-0815

Type:

Educational Exhibit

Keywords:

Imaging sequences, Contrast agent-intravenous, Colonography MR, MR, Pelvis, Genital / Reproductive system female, Gastrointestinal tract, Inflammation, Blood

Authors:

E. Alvarez Moreno¹, M. Jimenez De La Peña¹, L. Herraiz Hidalgo², T. Quintana Kwak³, M. Recio⁴, A. Alvarez Vazquez⁵, R. Cano Alonso⁶, C. Hayoun⁴, A. Fernández⁴; ¹Pozuelo de Alarcón, Madrid/ES, ²POZUELO, MADRID/ES, ³Las Palmas de Gran Canaria/ES, ⁴Pozuelo de Alarcon/ES, ⁵Pozuelo de Alarcón, So/ES, ⁶POZUELO de ALARCON, MADRID/ES

DOI:

10.1594/ecr2013/C-0815

DOI-Link:

https://dx.doi.org/10.1594/ecr2013/C-0815

Fig. 1: Figure 1: Anatomy of the anterior compartment. Sagittal T2-weighted MR image...

Fig. 2: Figure 2: Endometriosis of vesicouterine fornix. Sagittal and coronal...

Fig. 3: Figure 3: Anatomy of the posterior compartment. Sagittal andaxialT2-weighted MR...

Fig. 4: Figure 4: Anatomy of the posterior compartment. Patient with endometriosis and...

Learning objectives

Review the different types of endometriosis, superficial and deeply infiltrating. Determining optimal protocols for evaluating endometriosis with MRI imaging, establishing the utility of the classic sequences, MRI enterography or uro-MRI, the use of gadolinium and the application of vaginal or rectal gel, oriented along the patient’s clinical manifestations.

Background

The treatment of endometriosis is complete surgical excision. The superficial endometriosis or the endometriomas are only part of the spectrum of the disease and sometimes they are just the tip of the iceberg, a disorder that causes adhesions and can invade extraperitoneal structures and viscera. The deeply infiltrating endometriosis is defined as subperitoneal invasion at the depth of more than 5 mm and may affect fibromuscular pelvic structures, the urinary tract, the rectum and the gastrointestinal tract. Proper preoperatively management of these patients with an...

Imaging findings OR Procedure details

INTRODUCTION Endometriosis is defined as the presence of functional endometrial glands and stroma outside the endometrial cavity and myometrium. This ectopic tissue may appear as microscopic implants to large heme containing cysts (endometriomas). Due to their hormone-dependence they can cause bleeding, inflammation, fibrosis and adhesions, causing pelvic pain and infertility. It is difficult to determine precisely the prevalence of endometriosis, but it is estimated to affect 5-10% of the female population, with or without symptoms (1). The prevalence is higherin women withinfertilityor pelvic pain. Among...

Conclusion

MR imaging is the diagnostic method of choice for non-invasive assessment of endometriosis. An adequate knowledge of the sequences, the pathophysiology of the disease and the anatomic locations of affectation, allow an accurate diagnosis and appropriate surgical approach.

References

(1) Choudhary S, Fasih N, Papadatos D, Surabhi VR. Unusual imaging appearances of endometriosis. AJR Am J Roentgenol 2009 Jun;192(6):1632-44. (2) Berlanda N, Vercellini P, Fedele L. Rectovaginal or bowel endometriosis. 10-6-0011. Ref Type: Online Source (3) Del FC, Girometti R, Pittino M, Del FG, Bazzocchi M, Zuiani C. Deep retroperitoneal pelvic endometriosis: MR imaging appearance with laparoscopic correlation. Radiographics 2006 Nov;26(6):1705-18. (4) Coutinho A, Jr., Bittencourt LK, Pires CE, Junqueira F, Lima CM, Coutinho E, et al. MR imaging in deep pelvic endometriosis: a...