Learning objectives
We review a series of cases (2011/2014) of deep pelvic endometriosis and endometriosis in our center with the objective of describing the radiographic signs and the most frequent findings,
explaining radiological management and MRI protocol,
and evaluating the resonance role in the diagnosis and surgical planning.
Background
Endometriosis is defined as the presence of ectopic endometrial tissue outside the uterus.
Depending on its location,
three forms of pelvic endometriosis are defined:
- Endometrioma.
Endometriosis located in the ovarian,
with characteristic cyst formation due to cyclical bleeding.
- Superficial lesions or noninvasive peritoneal implants.
- Deep pelvic endometriosis or infiltrating endometriosis,
subperitoneal invasion greater than 5mm.
The ectopic endometrial tissue responds to hormonal stimuli causing variable degrees of bleeding and symptoms depending on its grade and location.
While superficial lesions and endometriomas are...
Findings and procedure details
1.
RM protocol
The diagnosis and evaluation of the extension of deep pelvic endometriosis is difficult employing only physical examination and conventional methods.
Exploratory laparoscopy considered as "gold standard" has limitations in assessing the subperitoneal space and under peritoneal adhesions,
which are frequent in this entityandprevent adequate visualization.
MRI due to its spatial resolution and its ability to tissue characterization is a precise technique in evaluating the extension of endometriosis and in detecting its complications.
Therefore,
provides information necessary to establish a map of the...
Conclusion
MRI has an important role in the diagnosis and treatment of endometriosis.
Because of its spatial resolution and the ability of tissue characterization is an accurate technique in the assessment of its extension and detecting its complications.
Therefore,
provides necessary information to establish a map of the disease and plan an appropriate surgical treatment.
Our role as radiologists involves the knowledge of radiologic manifestations of endometriosis and the most appropriate MRI protocol for an accurate interpretation.
References
- Coutinho A Jr,
Bittencourt LK,
Pires CE,
Junqueira F,
Lima CM,
Coutinho E,
Domingues MA,
Domingues RC,
Marchiori E.
MR imaging in deep pelvic endometriosis: a pictorial essay.
Radiographics.
2011 Mar-Apr;31(2):549-67.
doi: 10.1148/rg.312105144.
- Siegelman ES,
Oliver ER.
MR imaging of endometriosis: ten imaging pearls.
Radiographics.
2012 Oct;32(6):1675-91.
doi: 10.1148/rg.326125518.
- Marcal L,
Nothaft MA,
Coelho F,
Choi H.
Deep pelvic endometriosis: MR imaging.
Abdom Imaging.
2010 Dec;35(6):708-15.
doi: 10.1007/s00261-010-9611-y.
- McDermott S,
Oei TN,
Iyer VR,
Lee SI.
MR imaging of malignancies arising...