{"paper_id":"d7afb40f-2789-4d0b-94b4-b5d70da0ca0d","body_text":"ECR 2011 / C-1042\nPatterns of bowel involvement in deep infiltrating endometriosis: review of 284 consecutive cases\nCongress:\nECR 2011\nPoster Number:\nC-1042\nType:\nScientific Exhibit\nKeywords:\nMR, Pelvis\nAuthors:\nG. T. Bitti, G. Demurtas, S. SECCI; cagliari/IT\nDOI:\n10.1594/ecr2011/C-1042\nPurpose\nEndometriosis is defined as a chronic benign estrogen-dependent gynaecological disease (1), that affects millions of women of reproductive age: 10 to 15% of the female population.\nDifferent forms of disease manifestations have been described such as peritoneal endometriosis, adenomyosis uteri,\novarian endometriosis and deep infiltrating endometriosis (DIE).\nDeep infiltrating endometriosis (DIE) is diagnosed in 20% of women with endometriosis.\nBowel endometriosis is found in 5 to 12% of patients with endometriosis,\nwith colorectum representing 90% of all bowel locations (2). DIE is defined as the...\nMethods and Materials\nRetrospective evaluation on a PACS station of the MR examination in 284 consecutive patients referred for suspected endometriosis was done.\nMR studies were performed on a 1,5 MR unit with small FOV (20 cm) 3-5 mm FSET2 acquired on sagittal,\naxial and coronal planes,\n5 mm axial FSE T1 with and without fat saturation.\nWhen deemed necessary,\nan antiperistaltic drug and/or a paramagnetic contrast media were administered intravenously; no contrast media were introduced in the rectum/vagina.\nBowel endometriosis was identified and patterns of involvement were...\nResults\nRectosigmoid involvement by Endometriosis was observed to range from adhesion and tethering,\nup to extensive full thickness wall infiltration,\nin a spectrum of patterns that could be easily recognized on MR:\nType 1: thin mesorectal septa\nType 2: mesorectal mass with or without involvement of the uterosacral ligaments\nType 3: plaque with bowel retraction in a festooned appearance\nType 4: fan- or crescent-shaped mass infiltrating the wall.\nLess frequently small bowel and mesenteric involvement was observed.\nConclusion\nMultiplanar 3-5 mm FSE allowed recognition of different patterns of rectosigmoid involvement in Deep Infiltrating Endometriosis\nType 1: thin mesorectal septa,\nType 2: mesorectal mass with or without involvement of the uterosacral ligaments,\nType 3: plaque with bowel retraction in a festooned appearance,\nand\nType 4: fan- or crescent-shaped mass infiltrating the wall.\nLess frequently we observed small bowel lesions (tethering and loop adhesions) and mesenteric involvement (long septa,\nreticulation,\nincreased vascular markings,\ndecreased signal intensity).\nMR can be useful to stage DIE bowel involvement...\nReferences\n1) Giudice and Kao,\nEndometriosis.\nLancet 2004; 364:1789-1799 2004;364:1789-1799\n2) Darai E., Gynecol Obstet Fertil.\n2008 Dec; 36(12):1214-7\n3)van KaamJ., Hum Reprod. 2008 Dec; 23(12):2692-700 Fibromuscular differentiation in deeply infiltrating endometriosis is a reaction of resident fibroblasts to the presence of ectopic endometrium).\n4)Stepniewska A.,\nHum Reprod.\n2009 Jul; 24(7):1619-25.\nLaparoscopic treatment of bowel endometriosis in infertile women.\n5) Ferrero S., Fertil Steril. 2009 Jul; 92(1):41-6. Fertility after bowel resection for endometriosis.\n6) Hottat S., Radiology.\n2009 Oct;253(1):126-34.Endometriosis: contribution of 3.0-T pelvic MR imaging in...","source_license":"CC0","license_restricted":false}