Learning objectives
To support the importance ofMagnetic Resonance Imaging (MRI) in pelvic endometriosis evaluation
To illustrate the classic radiological findings in this imaging technique
Background
INTRODUCTION
Endometriosis is a common gynecologic condition defined asabnormal growth of endometrial tissue outside the uterine cavity.
The endometrioticimplants aremainlylocated in the pelvic peritoneum and ovarian lesions are characterized by cysts with hemorrhagic content.
They are recognized as deeply infiltrating endometriosis when they infiltrate adjacent structures at a depth of more than 5mm from the peritoneal surface.
EPIDEMIOLOGY AND PATHOGENESIS
Endometriosis is a chronic disease affecting about 10%of women inreproductive agewith a peak of incidence between30 and 45 years old[1].
The etiology and pathogenesis are...
Findings and procedure details
Agroup of clinical casesfrom our Department wasselected in order to illustrate thetypical appearance of pelvic endometriosis.
Using specific MRI sequences is particularly important as each affected site will have a characteristic finding (Table3).
OVARIAN ENDOMETRIOMAS
The ovaries are one of the most commonly affected sites by endometriosis,
described in20-40%of the cases[7].
Ovarian lesions may appear as superficial fibrotic implants with fibrous adhesions or as chronic retention cysts with cyclic bleeding,
recognized as endometriomas.
Transvaginal US is the imaging modality of choice for the diagnosis of...
Conclusion
Deep pelvic endometriosis is a concerning gynecologic disorder for wich surgery remains the best therapeutic option.
Pelvic MRI is a non-invasive method withhigh diagnostic accuracy for endometriosis with high sensibility to identify lesions hidden by adhesions and detect subperitoneal implants.
All radiologists must be familiarized with classic MRI findings of deep pelvic endometriosis as it has beenproven to be an essential technique in disease staging,
extensionevaluating and effectiveorientationfor surgical planning.
Personal information
Contact details:
Joana S.
Ferreira Pinto
Department of Imaging,
Centro Hospitalar do Porto - CHP
Largo do Prof.
Abel Salazar,
4099-001 Porto - Portugal
E-mail:
[email protected]
References
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