Endometriosis: A pictorial review by using magnetic resonance and trans-vaginal sonography

Saba, Luca
2010 · doi:10.1594/ecr2010/c-1202 · W6906202357
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This exhibit reviews endometriosis using MR imaging and transvaginal sonography, detailing imaging findings and diagnostic performance.

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This educational exhibit provides a comprehensive pictorial review of endometriosis imaging using magnetic resonance and trans-vaginal sonography. It outlines the physiopathology of the disease, noting that lesions undergo hormonal variations leading to chronic bleeding which influences MRI signal characteristics such as T1 hyperintensity in hemorrhagic nodules. The authors describe specific imaging features suggestive of endometriosis while analyzing diagnostic pitfalls and differential diagnoses with other pelvic pathologies. This paper is centrally about endometriosis — specifically focusing on the radiological identification and characterization of endometriotic lesions via MR and ultrasound.

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Keywords

Genital / Reproductive system female, Obstetrics (Pregnancy / birth / postnatal period), Pelvis Authors: L. Saba, S. Guerriero, R. Sulcis, M. Pilloni, G. Melis, G. Mallarini; Cagliari/IT DOI: 10.1594/ecr2010/C-1202 Learning objectives The purpose of this work is to give a comprehensive pictorial review of endometriosis by using MR imaging and trans-vaginal sonography.

Background

Endometriosis is one of the most prevalent conditions in women, in particular in the reproductive age group. The mean age at diagnosis is 25-29 years, but it is often greater in women who present with infertility rather than pelvic pain. Endometriosis is one of the most common gynaecological diseases, affecting more than 5.5 million women in North America alone.Endometriosis is defined as the presence of endometrial issue utside the endometrium and the myometrium and the most common locations of endometriosis are the ovaries and the... Imaging findings OR Procedure details Physiopathology and pathology of endometriosis To understand the MRI signal characteristic of endometriosis, it is important to remember that these nodules, like the intrauterine endometrium, are subject to hormonal variations and therefore present chronic bleeding. The T1 hyper intensity corresponds to the signal of the sub-acute hemorrhagic lesions whereas the low T2 and intermediate-to-low T1 signal to the fibrous stroma. The presence of a hemorrhagic nodule is a very specific finding for endometriosis but it is associated to low sensitivity because nodules may be not...

Conclusion

Endometriosis is a painful disorder of the female reproductive system and this pathology is frequently associated with pain and infertility. In this exhibit we describe MRI and TVS imaging features suggestive of endometriosis and their diagnostic performance by analyzing diagnostic pitfalls and differential diagnosis with other pathologies.

References

Sivyer P. Pelvic Ultrasound in women. World J Surg 2000;24:188-97.Freimanis MG, Jones AF. Transvaginal Ultrasonography. Radiol Clin Noth Am. 1992;30:955-976.Mais V, Guerriero S, Ajossa S, Angiolucci M, Paoletti AM, Melis GB. The efficiency of transvaginal ultrasonography in the diagnosis of endometrioma. Fertil Steril 1993; 60:776–780.Bazot M, Detchev R, Cortez A, Amouyal P, Uzan S, Darai E. Transvaginal sonography and rectal endoscopy sonography for the assessment of pelvic endometriosis: a preliminary comparison. Hum Reprod 2003;18:1686-92.Bazot M, Thomassin I, Hourani R, Cortez A, Darai E. Diagnostic accuracy...

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endometriosis

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