{"paper_id":"8a2c1456-e65a-464e-a8c8-706e833e1349","body_text":"ECR 2016 / C-0454\nBeyond shading: a comprehensive review of the MR features of pelvic endometriosis with laparoscopic correlation\nThis poster is published under an open license. Please read the disclaimer for further details.\nCongress:\nECR 2016\nPoster Number:\nC-0454\nType:\nEducational Exhibit\nKeywords:\nPathology, Diagnostic procedure, MR, Genital / Reproductive system female\nAuthors:\nN. Yang1, D. Kurda2, S. Esler1, T. Ma3, L. Ellet 3, P. J. Maher 3; 1Heidelberg/AU, 2Amman/JO, 3Melbourne /AU\nDOI:\n10.1594/ecr2016/C-0454\nLearning objectives\nAfter completion of this educational exhibit,\nreaders will be able to:\nRecognisethe key magnetic resonance (MR) featuresof pelvic endometriosis.\nBefamiliar with imaging “pearls” that facilitate disease recognition and evaluation.\nConsolidate understanding of the disease process,\naided by laparoscopic correlation.\nBackground\nEndometriosis is a common and important disorder affecting women of childbearing age.\nIt is the 3rd leading cause for gynaecologic hospitilisation and is a common cause of hysterectomy [1].\nLaparoscopy is the gold standard for diagnosis and staging of endometriosis.\nHowever,\nit is an invasive technique with potential to miss “blind spots” such as sub-peritoneal disease and lesions deep to adhesions.\nAdditionally,\nit can bedifficult for laparoscopists to assess the depth of bowel wall invasion.\nMRI can be used for the diagnosis of endometriomas and...\nFindings and procedure details\nOVARIAN ENDOMETRIOMA(Figs.\n2,\n3 and 4)\nEndometriomas demonstrate homogenous high T1 signal intensity (Fig.\n2) with no loss of signal on T1 fat saturated (T1FS) imaging (Fig.\n3).\nThe presence of multiple T1FS hyperintense adnexal cysts is highlyspecific for ovarian endometriomas [11].\nT2 signal intensity may be varied,\nbut a common and important feature is “shading”,\n(Fig.\n4).\nShading is defined as T2 shortening in an adnexal cyst that is hyperintense on T1.\nThe loss of T2 signal may be complete or layered in appearance...\nConclusion\nEndometriosis is a common condition with important sequelae in women of reproductive age.\nThe detection of deep infiltrating endometriosis (DIE) can be difficult and easily under-diagnosedon MRI,\nas these lesions are low on T2 weighted sequences and are less likely to contain T1 hyperintense foci within.\nA good knoweldge of pelvic anatomy and the MR findings of pelvic endometriosis is important for DIE diagnosis,\nevaluation of disease extent and aidingsurgical planning.\nReferences\nWinkel CA.\nEvaluation and Management of Women with Endometriosis.\nObstetrics and Gynaecology 2003,\n102 (2):397-408.\nDonnez J.Endometriosis: enigmatic in the pathogenesis and controversial in its therapy.\nFertil Steril2012,98 (3):509-10.\nBurney RO,\nGuidice LC.Pathogenesis and pathophysiology of endometriosis.Fertil Sertil 2012,98 (3):511-9.\nWitz C.\nPathogenesis of Endometriosis.\nGynecol Obstet Invest 2002,\n53 (suppl 1):52-62.\nJenkins S,\nOlive DL,\nHaney AF.\nEndometriosis: pathogenetic implications of the anatomic distribution.\nObstet Gynecol 1986,\n67:335-338.\nRidley JH.\nThe histogenesis of endometriosis: A review of facts and fancies.\nObstet Gynecol Surv 1968,...","source_license":"CC0","license_restricted":false}