Findings of Pelvic Endometriosis at Transvaginal US, MR Imaging, and Laparoscopy

Luciana Pardini Chamié, Roberto Blasbalg, Ricardo Pereira, Ricardo Mendes Alves Pereira, Gisele Warmbrand, P. Serafini, Paulo Cesar Serafini
Radiographics : a review publication of the Radiological Society of North America, Inc · 2011 · vol. 31(4) , pp. E77–E100 · doi:10.1148/rg.314105193 · PMID:21768230 · W2109580987
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Transvaginal ultrasound and MRI accurately detect pelvic endometriosis, with ultrasound being reliable for rectosigmoid lesions and MRI for complex cases, revealing characteristic imaging features for peritoneal implants and endometriomas.

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Abstract

Endometriosis is a common multifocal gynecologic disease that manifests during the reproductive years, often causing chronic pelvic pain and infertility. It may occur as invasive peritoneal fibrotic nodules and adhesions or as ovarian cysts with hemorrhagic content. Although findings at physical examination may be suggestive, imaging is necessary for definitive diagnosis, patient counseling, and treatment planning. The imaging techniques that are most useful for preoperative disease mapping are transvaginal ultrasonography (US) after bowel preparation, and magnetic resonance (MR) imaging. Initial transvaginal US is a reliable technique for detecting rectosigmoid endometriotic lesions. MR imaging is indicated as a complementary examination in complex cases of endometriosis with extensive adhesions and ureteral involvement. Peritoneal endometriotic implants are typically hypoechoic on transvaginal US images and demonstrate low signal intensity on T2-weighted MR images. Endometriotic implants most commonly are found in retrocervical and rectosigmoid sites, followed by the vagina, bladder, and ureters. Cysts with low-level internal echoes and echogenic peripheral foci at transvaginal US are suggestive of endometriomas. MR imaging has high specificity for identifying endometriomas, which are characterized by high signal intensity on T1-weighted images and low signal intensity on T2-weighted images. Correlation of the radiologic imaging features of endometriotic lesions with their laparoscopic appearances may help improve individual proficiency in the radiologic diagnosis of endometriosis.

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Condition tags

mesh:D004715endometriosischronic_pelvic_paininfertility

MeSH descriptors

Endometriosis Laparoscopy Magnetic Resonance Imaging Pelvis Pelvis Ultrasonography Endometriosis Female Humans Laparoscopy Magnetic Resonance Imaging Pelvis Ultrasonography Vagina Vagina Vagina

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Papers in the corpus that this work cites (lower rings, blue) and that cite this one (upper rings, green). Dot size scales with the paper's in-corpus citation count — bigger dot = more influential within the endo/adeno field. Click a dot to open that paper. [ expand to 2 hops ] — adds papers reached through this work's immediate citers/citees. Heavier; up to 60 extra dots.

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