Endometriosis imaging: What to look for.

ELmouden, hanane
2022 · doi:10.26044/ecr2022/c-16711 · W6964729712
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This educational exhibit details ultrasound and MRI features of endometriosis, highlighting ultrasound as a first-line investigation and MRI as the best technique for preoperative staging.

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This educational exhibit reviewed imaging approaches for endometriosis, focusing on pelvic ultrasound and MRI features, including the use of fat-suppressed MRI, and discussed key sonographic characteristics and differential diagnoses. It describes ultrasound as the first-line investigation for suspected endometriosis using trans-abdominal and trans-vaginal scanning to characterize ovarian cystic lesions, highlighting typical endometrioma findings such as diffuse low-level internal echoes, multilocularity, and hyperchoic foci in the wall, while noting differential diagnoses like corpus luteum, teratoma, cystadenoma, and fibroma. It states that MRI is the best imaging technique for preoperative staging to support surgical planning and multidisciplinary team work, with the caveat that diagnosis relies on a combination of clinical history and invasive/non-invasive techniques rather than imaging alone. This paper is centrally about endometriosis — it focuses on what to look for on ultrasound and MRI in endometriosis imaging.

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Keywords

Genital / Reproductive system female, Pelvis, MR, Ultrasound, Surgery, Haemorrhage Authors: H. E. ELmouden, D. LAOUDIYI, K. CHBANI, S. SALAM, L. OUZIDANE DOI: 10.26044/ecr2022/C-16711 Learning objectives -Show the ultrasound aspect of endometriosis-Illustrate the magnetic resonance imaging (MRI) features of endometriosis-Evaluate the utility of fat-suppressed magnetic resonance imaging (MRI) in the diagnosis of endometriosis.

Background

Endometriosis is a chronic gynaecological condition affecting women of reproductive age and may cause pelvic pain and infertility. It is characterized by the growth of functional ectopic endometrial glands and stroma outside the uterus and includes three different manifestations: ovarian endometriomas, peritoneal implants, deep pelvic endometriosis. The primary locations are in the pelvis; extrapelvic endometriosis may rarely occur. Diagnosis requires a combination of clinical history, invasive and non-invasive techniques The imaging techniques have a fundamental role in the diagnosis of endometriosisPelvic ultrasound is the primary... Findings and procedure details Ultrasound is the first line investigation of women suspected of having endometriosis due to its wide availability, good resolution, low cost and lack of ionising radiation. The main focus of trans-abdominal (TA) and trans-vaginal (TV) scanning is to visualise the ovaries and to completely characterise any cystic lesions in terms of internal echogenicity and wall morphology [10].Characteristic sonographic features of endometriomas are diffuse low-level internal echos, multilocularity and hyperchoic foci in the wall. (Figure 1) (Figure 2) Differential diagnoses include corpus luteum, teratoma, cystadenoma, fibroma,...

Conclusion

MRI represents the best imaging technique for preoperative staging of endometriosis, in order to choose the more appropriate surgical approach and to plan a multidisciplinary team work Personal information and conflict of interest h. E. ELmouden: Nothing to disclose D. LAOUDIYI: Nothing to disclose K. CHBANI: Nothing to disclose S. SALAM: Nothing to disclose L. OUZIDANE: Nothing to disclose

References

1-Pietro Valerio,Renato Farina,Stephano Palmucci,Maria Coronella,Pietro Milone Antonio Cianci and Giovanni Carlo Ettorre Endometriosis: clinical features, MR imaging findings and pathologic correlation 2018 Apr; 9(2): 149–172 2-Chamié LP, Blasbalg R, Pereira RM, Warmbrand G, Serafini PC. Findings of pelvic endometriosis at transvaginal US, MR imaging, and laparoscopy. Radiographics. 2011;31(4):E77–100. doi:10.1148/rg.314105193 3- Hsu AL, Khachikyan I, Stratton P. Invasive and noninvasive methods for the diagnosis of endometriosis. Clin Obstet Gynecol. 2010;53(2):413–419. doi:10.1097/GRF.0b013e3181db7ce8. 4-Viala-Trentini M, Maubon A, Filhastre M, Georges P, Rouanet J-P (2006) Imagerie de l’hypofertilité de...

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endometriosis

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