Learning objectives
The aim is to describe the common and rare radiological findings of ovarian and extra-ovarian endometriomas.
Background
Endometriosis is a chronic disorder predominantly affecting women of childbearing age.
It is defined as presence of ectopic endometrial glands and stroma outside the uterus.
This condition manifests in as many as 10% of premenopausal woman and is an important cause of chronic pelvic pain and infertility.
Several hypotheses have been proposed to explain the pathogenesis of endometriosis,
but the most widely accepted theory is metastatic implantation of endometrial tissue from retrograde menstruation.
Endometriosis can involve almost any body part with a notary exception,
the...
Findings and procedure details
On ultrasound,
ovarian endometriomas appear homogeneous,
hypoechoic cyst with diffuse low-level echoes,
commonly termed ‘ground glass’.
Endometrioma can be multi-locular and have thin or even thick septations.
The close proximity of both ovaries is known as "kissing ovaries" which is caused by adhesions and is considered a sign of pelvic endometriosis.
The MRI standard protocol which is mostly used is,
T2-weighted fast spin echo sequence,
T1- weighted fast spin echo sequence,
and T1-weighted fast spin echo fat saturation sequence.
The T1-weighted fat saturated technique plays...
Conclusion
Although laparoscopy continues to be the gold standard for the diagnosis of endometriosis,
MRI is increasingly being used,
especially to evaluate deep disease,with high sensitivity and specificity.
Ultrasound is predominantly used to evaluate the ovaries and to assess the pelvis in the workup for pelvic pain or infertility.
Personal information
Dr Nehal Mohamed Saloum.
Clinical Fellow,
Diagnostic Imaging.
Hamad Medical Corporation,
Doha,
Qatar.
Email:
[email protected].
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