- To emphasize the role of MRI in the detection of foci of deep endometriosis of the posterior pelvic compartment.
- To show the correct acquisition protocol,
the main features and the typical localizations of deep endometriosis of the posterior pelvic compartment.
Endometriosis is a chronic inflammatory disease affecting mainly women during the reproductive age and it is characterized by the presence of endometrial tissue outside the endometrium .
Endometriosis is a multi-factorial disorders with an unclear etiology and pathogenesis.
Three are the main theories proposed.
The metastatic theory, which is the most widely accepted,
assumes that endometrial cells are transported by retrograde menstrual flux on the surface of the peritoneal cavity.
Vascular-lymphatic pathways and intraoperative implants were also proposed as routes of metastatic spread [1-2].
Findings and procedure details
When endometriosis invades the subperitoneal space for more than 5 mm in depth,
it's called deep endometriosis .
sensitivity and specificity of MRI in the evaluation of deep endometriosis were > 90% in different studies [5-6].
It is frequently associated with dysmenorrhea,
urinary tract symptoms and infertility .
Posterior compartment of the pelvis is the most common localization of deep endometriosis [3-4].
Fig.1-4 show the main anatomical sites of disease.
A correct execution of the MRI examination is based on...
Although laparoscopy is the best method in the diagnosis of endometriosis ,
MRI represents the most specific and sensitive non-invasive technique in the assessment of deep infiltrating endometriosis of the posterior pelvic compartment,
allowing a proper management of patients.
The knowledge of the typical features and sites of disease together with a correct execution of the MRI examination,
are fundamental to recognize endometriosis.
Carmelo Sofia M.D.
Division of Radiology
Hospital of Chioggia
Strada Marina 500,
Sottomarina di Chioggia 30015,
N Engl J Med 1993; 328:1759–1769.
Mezzetti TP Jr.
Endometriosis: radiologic-pathologic correlation.
Coutinho A Jr,
Pires CE et al.MR imaging in deep pelvic endometriosis:a pictorial essay.
Deep endometriosis: definition,
J Am Assoc Gynecol Laparosc.2004; 11:153–161
Posterior cul–de–sac obliteration associated with endometriosis: MR...