Complications of endometrioma: a challenging diagnosis

Genital / Reproductive system female, Pelvis, CT, MR, Ultrasound, Complications, Cysts Authors: I. BEN JEMAA, S. Ayadi, C. Uzan, G. CANLORBE, J.-P. Akakpo, J. BELGHITI, Y. Badachi, O. Lucidarme DOI: 10.26044/ecr2024/C-24349 Learning objectives To identify the different complications of endometrioma.To describe their specific imaging features.

Endometriosis affects 10% of reproductive age women, according to the World Health Organization (1). Ovary is one of the most common site of endometriosis (2). Endometrioma has a typical MRI aspect and is, usually, easily diagnosed. But when a complication occurs, this appearance changes, making the diagnosis more challenging. Although rare, endometrioma complications must be familiar to all radiologists because their diagnosis is based largely on imaging evidence. Findings and procedure details Endometrioma is typically, homogeneous on MRI, with high signal intensity on T1-weighted fat-suppressed image and “T2 shading” which consists of low signal on T2-weighted image (T2 shortening), affecting variable portions of the cyst. It may involve only a small portion of the cyst, typically layering dependently. Bilaterality is also very common in endometriomas.[Fig 1]This typical aspect changes in case of complication. Main endometrioma complications are malignant transformation, rupture, infection and decidualization during pregnancy. In all this cases, a heterogeneous signal intensity and a loss of...

Complicated endometrioma is rare, but should be considered in the presence of any atypical ovarian cyst, especially if associated with other features of endometriosis. The knowledge of its imaging aspects by the radiologist is necessary, given his important role in diagnosis, follow-up and therapeutic decision. Personal information and conflict of interest I. Ben Jemaa: Nothing to disclose S. Ayadi: Nothing to disclose C. Uzan: Nothing to disclose G. Canlorbe: Nothing to disclose J-P. Akakpo: Nothing to disclose J. BELGHITI: Nothing to disclose Y. Badachi: Nothing to disclose O. Lucidarme: Nothing to disclose

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