Magnetic resonance imaging of deep and visceral pelvic endometriosis: Examination technique and imaging findings

Authors: G. Restaino, M. Missere, M. Ciuffreda, E. Cucci, M. Occhionero, G. Sallustio; Campobasso/IT DOI: 10.1594/ecr2009/C-308 DOI-Link: Learning objectives In the young patient, MRI may be performed if a gynecologic disorder is not suspected at first, especially if US findings are equivocal or the abnormality extends beyond the field of view of the sonographic probe. Moreover, MRI is useful whenever further characterization of pelvic disorder is required. In fact, many causes of pelvic disorders and of endometriosis in particular demonstrate characteristic MRI findings. In this work we describe the MRI examination technique and the MRI appearances of pelvic endometriosis.Endometriosis represents a common and important...

Endometriosis is classically defined as the presence of endometrial glands and stroma outside the uterine cavity and musculature. Pelvic endometriosis includes ovarian, peritoneal (vesico-uterin pouch, Douglas pouch), subperitoneal (utero-sacral ligaments, recto-vaginal septum) and solid visceral (sigmoid colon, rectum, bladder) localization of the disease. Endometrial mucosa foci within the myometrium, sometimes defined as internal endometriosis, are different entities from endometriosis, known as adenomyosis. Although adenomyosis and endometriosis may be present at the same time in the same patient, they represent different pathogeneses, symptoms, and epidemiologies and... Imaging findings OR Procedure details MRI technique The MR examination requires 6 h of prior fasting and is carried out in our institution with a 1.5 T superconducting magnet and phased-array surface coils to obtain the best signal-to-noise ratio at a given slice thickness. A myorelaxant agent (Glucagon, 1 mg or hyoscine butilbromide, 20 mg) is intra-muscolarly injected just before starting the procedure in order to reduce artifacts caused by intestinal peristalsis. Patient is invited to void 2 hours before the examination in order to have a moderately filled bladder...

Endometriosis represents a common and important clinical problem of women of childbearing age. Laparoscopy is still the gold standard for definitive diagnosis and staging of endometriosis, although hidden and well-adhering lesions may go unrecognized. However, due to its invasiveness, this method is to be limited to those patients with an almost certain preoperative diagnosis, taking the best advantage of the therapeutic valence Magnetic resonanc imaging is able to directly depict ovarian, peritoneal and deep endometriosis with a high degree of accuracy particularly at the torus... Personal Information · Gennaro Restaino · Was born in Salerno (Italy) on July 6th 1970 · He obtained the Degree of Medical Doctor on October 22th 1997 at the Medical School of Catholic University of Sacred Heart, “A. Gemelli” University Hospital, Rome, · He achieved the title of Specialist in Radiology on December, 6th 2002 at Radiology Department of the Medical School of Catholic University of Sacred Heart, “A. Gemelli” University Hospital, Rome · He has been attending as Visiting fellow the Cardiovascular Magnetic Resonance Unit of...

Olive DL, and Barrie Schwartz L. Endometriosis. N Engl J Med. 1993 Jun 17328(24):1759-69. Del Frate C, Girometti R, Pittino M, et al. Deep Retroperitoneal Pelvic Endometriosis: MR Imaging Appearance with Laparoscopic Correlation. RadioGraphics 2006 26:1705&ndash1718. Kinkel K, Frei KA, Balleyguier C, et al. Diagnosis of endometriosis with imaging: a review. Eur Radiol (2006) 16: 285&ndash298. Bazot M, Darai E, Hourani R, et al. Deep Pelvic Endometriosis: MR Imaging for Diagnosis and Prediction of Extension of Disease. Radiology 2004 232:379&ndash389 Comiter CV. Endometriosis of the...