Magnetic Resonance Manifestations of Decidualized Endometriomas During Pregnancy
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Magnetic resonance imaging of decidualized ovarian endometriomas in pregnant women reveals hyperintense mural nodules on T2-weighted and diffusion-weighted images, with higher apparent diffusion coefficients than malignant nodules.
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Abstract
OBJECTIVE: Decidual changes of endometrial tissue in endometriomas during pregnancy may manifest as mural nodules and mimic malignant transformation. We evaluated magnetic resonance findings of decidualized ovarian endometriomas for the differentiation from malignant transformation. METHODS: Magnetic resonance manifestations of 5 decidualized ovarian endometriomas were evaluated. High b-value diffusion-weighted images were performed in 3 cases. RESULTS: The mural nodules were demonstrated as linear, small nodular, broad-based nodular, or polypoid structures, which showed prominent hyperintensity on T2-weighted images and on diffusion-weighted images similar to normal endometrium or placenta. The apparent diffusion coefficient of decidualized mural nodules was significantly higher than that of malignant mural nodules of 7 ovarian cancers. CONCLUSIONS: Endometrioma with prominent hyperintense mural nodules on T2-weighted images in a pregnant woman is highly suggestive for decidualized endometriomas. Diffusion-weighted images with the apparent diffusion coefficient measurement may help the diagnosis of this rare entity.
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Cited by (38)
- Imaging Diagnosis of Decidualized Endometriotic Cysts 2025
- Differential Diagnosis of Ovarian Tumors with Solid and Cystic Components: D. Imaging Diagnosis of Polypoid Endometriosis 2025
- Endometriosis, a common but enigmatic disease with many faces: current concept of pathophysiology, and diagnostic strategy 2024
- Natural history of endometriosis in pregnancy: ultrasound study of morphology of deep endometriosis and ovarian endometrioma 2023
- MRI of Borderline Epithelial Ovarian Tumors: Pathologic Correlation and Diagnostic Challenges 2022
- Decidualized ovarian endometrioma mimicking malignancy in pregnancy: a case report and literature review 2022
- MRI in the Diagnosis of Endometriosis and Related Diseases 2022
- MR Imaging of Endometriosis of the Adnexa 2022
- MR findings of polypoid endometriosis of female genital organs: report of three cases 2022
- Magnetic resonance imaging findings of cystic ovarian tumors: major differential diagnoses in five types frequently encountered in daily clinical practice 2022
- Endometriosis and adverse pregnancy outcome 2021
- Images pièges et difficultés diagnostiques dans le cadre d’un bilan d’endométriose pelvienne : intérêt de la confrontation radioclinique 2021
- Endometriosis in pregnancy 2020
- MR findings for differentiating decidualized endometriomas from seromucinous borderline tumors of the ovary 2020
- The Complementary Role of Ultrasound and Magnetic Resonance Imaging in the Evaluation of Endometriosis: A Review 2019
- The effect of pregnancy on endometriosis—facts or fiction? 2018
- Computed diffusion-weighted imaging for differentiating decidualized endometrioma from ovarian cancer 2016
- A systematic review on endometriosis during pregnancy: diagnosis, misdiagnosis, complications and outcomes 2015
- Decidualized Ovarian Endometrioma in a Pregnant Woman Mimicking Ovarian Malignancy: Magnetic Resonance Imaging and Ultrasonographic Findings 2015
- Beyond infertility: obstetrical and postpartum complications associated with endometriosis and adenomyosis 2015
- A Case of Bilateral Decidualized Endometriomas during Pregnancy: Radiologic-pathologic Correlation. 2015
- Complex abdominopelvic endometriosis: the radiologist’s perspective 2015
- Natural history of ovarian endometrioma in pregnancy 2014
- MR Imaging of Endometriosis 2014
- Magnetic Resonance Imaging Manifestations of Decidualized Endometriotic Cysts 2014
- Endometriosis 2014
- Decidualisation of ovarian endometriomas in pregnancy: a management dilemma. A case report and review of the literature 2014
- Imaging in gynecological disease (10): clinical and ultrasound characteristics of decidualized endometriomas surgically removed during pregnancy 2014
- A Case Presentation: Decidualized Endometrioma Mimicking Ovarian Cancer during Pregnancy 2013
- Detection and differential diagnosis of suspected malignant transformation of an endometrioma during pregnancy 2013
- The vanishing endometrioma: the intriguing impact of pregnancy on small endometriotic ovarian cysts 2013
- MR Imaging : Ten Imaging Pearls 1 2012
- Cutaneous Decidualized Endometriosis in a Nonpregnant Female 2012
- MR Imaging of Endometriosis: Ten Imaging Pearls 2012
- The effect of the hormonal milieu of pregnancy on deep infiltrating endometriosis: serial ultrasound assessment of changes in size and pattern of deep endometriotic lesions 2011
- Polypoid endometriosis of the bladder during pregnancy mimicking urachal carcinoma 2011
- 10.1016/s1879-8543(19)42824-3 2000
- 10.1016/s1879-8543(19)60537-9 2000
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- europepmc
- last seen: 2026-06-13T06:22:48.782012+00:00
- openalex
- last seen: 2026-06-10T17:14:06.276822+00:00
- pubmed
- last seen: 2026-05-13T22:14:30.652814+00:00
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