Endometriosis: A multimodality approach to imaging the pelvis and beyond

Tissue characterisation, Outcomes, Obstruction / Occlusion, Structured reporting, Complications, Ultrasound, MR, CT, Pelvis, Genital / Reproductive system female, Abdomen Authors: D. Valencia, R. Wilkins, J. Smith, P. L. Moyle, E. Sala, H. C. Addley, S. Freeman; CAMBRIDGE/UK DOI: 10.26044/ecr2019/C-3027 Learning objectives Identify common radiological features of endometriosis Reconise unusual disease sites Understand the treatment-planning role of radiology

Common sites of endometrial deposits are within the pelvis affecting the ovaries, fallopian tubes, uterosacral ligaments and pouch of Douglas.Endometriosis can also exist in previous Caesarean-section scars. Endometriosis presents with a range of symptoms: chronic pelvic pain, dyspareunia, dysmenorrhoea and infertility. The site of endometriotic deposits relates to the presenting symptoms. For example, pelvic / abdominal adhesions may cause chronic, non-cyclical pelvic pain. Whereas, endometriotic deposits on uterosacral ligaments can cause dyspareunia. Bladder and ureteric involvement may cause irritative bladder symptoms, frequency and suprapubic discomfort.... Findings and procedure details Ultrasound Advantages: No ionising radiation Quicker and cheaper examination when compared to MR Dynamic study with real time feedback from patients for areas of concern Disadvantages: Limited field of view Operator dependent US is readily available and typically the first imaging test in suspected endometriosis. However, it requires knowledge and understanding of endometriosis, to identify disease. Endometriomas are the most commonly seen manifestation of endometriosis and are seen on US as cysts containing homogeneous low level echoes (Fig. 1). Endometriomas may be either unilateral or...

Endometriosis is a common disease with significant associated morbidity. Radiologists and sonographers play a crucial role in the diagnosis. Ultrasound, CT and MRI can have important roles the diagnosis of endometriosis due to the wide spectrum of presentations as demonstrated. We have found that MRI in particular is a very useful tool in pre-operative planning in complex cases involving the urinary and gastrointestinal tract. It is important to recognise the common imaging features of endometriosis and be aware of the potential areas for endometriotic deposits. Personal information D.Valencia - Specialty Registrar, Radiology, Addenbrooke's Hospital, Cambridge, UK R. Wilkins - Sonographer, Radiology, Addenbrooke's Hospital, Cambridge, UK J. Smith - Specialty Registrar, Radiology, Addenbrooke's Hospital, Cambridge, UK P. L. Moyle - Consultant, Radiology, Addenbrooke's Hospital, Cambridge, UK E. Sala - Consultant, Radiology, Addenbrooke's Hospital, Cambridge, UK H. C. Addley - Consultant, Radiology, Addenbrooke's Hospital, Cambridge, UK S. Freeman - Consultant, Radiology, Addenbrooke's Hospital, Cambridge, UK

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