Deep recto-sigmoid endometriosis: role of magnetic resonance imaging

Pelvis, Genital / Reproductive system female, Colon, MR, Diagnostic procedure, Obstetrics Authors: C. Sofia1, M. A. Marino1, L. Di Grazia2, N. Boscolo Bariga2, G. Di Salvo2, A. Blandino3, A. Tregnaghi2; 1MESSINA, AT/IT, 2Chioggia/IT, 3MESSINA/IT DOI: 10.26044/ecr2019/C-0988 Learning objectives To show themainMRIfindingsofdeependometriosisinvolving therectosigmoidregion.

- Endometriosis is a chronic disorder characterized by thepresence of ectopic endometrial tissue - Usually, it affects women during their reproductive years - Endometriosis is a multi-factorial disease with an unclear aetiologyand pathogenesis - It is distinguished in superficial and deep endometriosis - Deependometriosis is defined as the presence ofan infiltrating lesion into an organ wall or thesubperitonealspace for more than 5 mm in depth - The posterior pelvic compartment is the most frequent localization of deep endometriosis - Rectosigmoid colon is the most common... Findings and procedure details Our MRI protocol for patients suspected to have pelvic endometriosis consists of : - axial, sagittal and coronal T2w TSE images - axial T2w SPAIR images - axial T1w TSE images - axial and sagittal T1w SPAIR images after intravenous contrastmedium injection (if necessary) Slice thickness: 3-4 mm - Vaginal and rectal cavities fluid distension is recommendable for a better depiction of small parietal lesions, improving sensitivity andspecificy(Fig.1) - Contrast medium injection is not mandatory; it can help in distinguish deep endometriosis from scars, allowing...

Radiologist should be aware of the main MRI features and localizations of deep rectosigmoid endometriosis to recognize the disease and to allow a correct presurgical and tailored clinical management Personal information Carmelo Sofia M.D. Division of Oncologic Radiology Policlinico Universitario "Gaetano Martino", Via Consolare Valeria 1, 98125 Messina , Italy [email protected]

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