{"paper_id":"cc71224c-4dd7-4c5c-b925-8f1a57da2a80","body_text":"ECR 2013 / C-2024\nMultidisciplinary approach of endometriosis: do’s and dont’s\nCongress:\nECR 2013\nPoster Number:\nC-2024\nType:\nEducational Exhibit\nKeywords:\nPathology, Education, Comparative studies, MR, Genital / Reproductive system female\nAuthors:\nA. Guerra, A. Setubal, F. Osorio, F. Faustino, D. Vilarinho, V. Mascarenhas, A. Gaspar, H. M. R. Marques; Lisbon/PT\nDOI:\n10.1594/ecr2013/C-2024\nLearning objectives\nTo correlate the manifestations of endometriosis with Magnetic Resonance Imaging (MRI) and Laparoscopy (LAP) as well as to explain how to work on a multidisciplinary basis.\nBackground\nEndometriosis affects approximately 12% of all reproductive-age women,\nleading to different types of pain,\ncomplications related to the spread of the disease and finally to infertility.\nEndometriosis is defined as the presence of functional endometrial glands and stroma outside the uterine cavity (1).\nThis functional tissue responds to hormonal stimulation with various degrees of pelvic haemorrhage resulting in bleeding inflammatory response at adjacent tissues (2).\nSee(FIG 1): The pathophysiology of the endometriotic lesions\nThese two phenomena will cause two types of tissue changes: endometrial glands...\nImaging findings OR Procedure details\nPELVIC ENDOMETRIOSIS\nThe most commonly affected sites by pelvic endometriosis are the pelvic organs and peritoneum (4).\nTo understand the different LAP/MRI aspects of pelvic endometriosis we classified the endometriosis in three types:\nA) Superficial peritoneal lesions\nB) Ovarian endometrioma\nC) Deep or solid infiltrating endometriosis.\nA) Superficial Peritoneal lesions:\nAt laparoscopy the endometriosis typically appears as superficial “powder- burn” or “gunshot” lesions on the ovaries,\nserosal surfaces and peritoneum – black,\ndark-brown or blueish puckered lesions,\nnodules or small cysts containing old haemorrhage surrounded...\nConclusion\nMRI allows characterization of endometriomas,\nextraovarian endometriotic implants and associated inflammation and fibrosis (all severe deep endometriosis) with a very good correlation with laparoscopy findings.\nMRI provides a road map that allows the surgeon to establish a surgical strategy to minimize the length and invasiveness of the laparoscopy providing an optimal guide to identify and treat all extra peritoneum lesions in severe endometriosis.\nReferences\n1) MR Imaging in Deep Pelvic endometriosis: A Pictorial Essay.\nCoutinho,\nAntônio; Kayat Bittencourt,\nLeonardo; E Pires,\nCíntia; Junqueira,\nFlávia; Lima,\nCláudio Márcio; Coutinho,\nElisa; Domingues,\nMarisa ; Domingues,\nRomeu ; Marchiori,\nEdson.\nRadiographics 2011; 31: 549-567.\n2) Findings of Pelvic endometriosis at transvaginal US,\nMR Imaging and Laparoscopy.\nChamié ,Luciana; Blasbald Roberto; Alves Pereira,\nRicardo; Warmbrand,\nGisele; Serafini,\nPaulo Cesar.\nRadiographics 2011; E77-E100.\n3) Deep pelvic Endometriosis: MR Imaging.\nMarcal,\nLeonardo; Nothaf,\nM.\nAngela; Coelho,\nFrancisco; Choi,\nHaesun.\nAbdominal Imaging 2010; 35:708-715.\n4) ESHRE...\nPersonal Information\nAdalgisa Guerra,\nImagiology Department,\nHospital da Luz,\nLisbon,\nPortugal.\n[email protected]","source_license":"CC0","license_restricted":false}