Learning objectives
1- Review the anatomy of the female pelvis and precise the common areas of endometriosis lesions.
2- Precise the classification of pelvic endometriosis (superficial and deeply infiltrating) .
3- Optimize MRI protocols and determine the radiological semiology of pelvic endometriosis including pathognomonic signs and various locations to ensure a complete lesion mapping.
Background
Endometriosis is a chronic gynecological condition affecting women of reproductive age.
Pathologically,
it is the result of functional endometrium located outside the uterus.
It may vary from microscopic endometriotic implants to large cysts (endometriomas).
Symptoms are misleading ranging from asymptomatic forms to disabling pelvic pain,
infertility,
or adnexal masses.
Although laparoscopy continues to be the gold standard for the diagnosis ,
MRI is increasingly being used to determine the extent of deep infiltrating endometriosis,
especially when laparoscopic inspection is limited by adhesions.
It offers precise...
Findings and procedure details
Our study series focused on about twenty patients whose age range varies between 26 and 52 years.
Deep pelvic endometriosis was the most prominent form (17 cases) and included a large variety of lesions (small infiltrating implants and nodules,
deep pelvic ligamentous adhesions and solid visceral infiltrating endometriosis).
The most affected locations were the Fallopian tubes,
pelvic Peritoneum,
Pouch of Douglas or Cul-de-Sac, Rectal-vagina septum and the Uterosacral ligaments.
The ovaries represent also a frequent location of endometriosis (12 cases) with lesions wich are often...
Conclusion
Endometriosis is a common condition with major and often devastating consequences to the patient.
Laparoscopy,
which allows visualization of superficial endometriosis,
is complemented by pelvic MR imaging.
It‘s the optimal non invasive tool that offers precise preoperative lesion mapping of the deep pelvic endometriosis.
So that radiologists should be familiar with the imaging findings of endometriosis in various anatomical locations .
References
Marc Bazot,
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magnetic resonance imaging,
and other techniques,
Fertility and Sterility® Vol.
108,
Elsevier Inc,
2017 0015-0282.
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Bourgiotia and al: MR imaging of endometriosis: Spectrum of disease,
Elsevier Masson SAS,
2211-5684/© 2017.
Evan S,
and al: MR Imaging of Endometriosis: Ten Imaging Pearls1,RSNA,
2012,RadioGraphics 2012; 32:1675.
M.
Bazot and al: European society of urogenital radiology (ESUR) guidelines:MR imaging of pelvic endometriosis,Springerlink,2016,
doi:10.1007/s00330-016-4673-z.
Caterina E.
and al: Imaging for the evaluation of endometriosis and adenomyosis,Elsevier Ltd,
2014,1521-6934....