Endometriosis

Endometriosis is a common yet underestimated pathology, defined by the presence of ectopic endometrial tissue. It can be asymptomatic but can also cause chronic pain and/or infertility through various mechanisms. Pelvic ultrasound is the first-line examination for suspected endometriosis. MRI is however the reference examination. The MRI protocol is nonconsensual. However, digestive preparation before the exam is essential, and imaging should include three different T2 planes, a plane in T1 DIXON or T1 and T1 Fat Sat, and imaging of the kidneys to evaluate potential obstruction. Superficial endometriosis is underestimated at imaging but can appear as peritoneal implants and/or adhesions. Adnexal endometriosis is mainly represented by endometriomas that are typical on MRI and may become complicated by infection, rupture, decidualization, and rarely degeneration. Deep pelvic endometriosis is the one most often responsible for symptoms. It typically appears as nodular irregular retractable thickening in hyposignal T2, possibly with cystic of hemorrhagic content, and can affect all components of the pelvis and beyond, including the abdominal wall and diaphragm. The torus and uterosacral ligaments are the most frequently affected sites. A precise cartography of all the lesions using a compartmental approach is mandatory to plan the potential treatment. Access this chapter Tax calculation will be finalised at checkout Purchases are for personal use only Similar content being viewed by others

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