Magnetic resonance imaging of deep pelvic endometriosis

Genital / Reproductive system female, Obstetrics (Pregnancy / birth / postnatal period), Pelvis Authors: L. Saba, S. Guerriero, R. Sulcis, M. Pilloni, G. Melis, G. Mallarini; Cagliari/IT DOI: 10.1594/ecr2010/C-1233 Learning objectives The purpose of this work is To discuss and analyze Magnetic Resonance Imaging (MRI) technique to study deep pelvic endometriosis and to compare MRI, Computed Tomography and Sonography in the study of deep pelvic endometriosis

Endometriosis is one of the most prevalent conditions in women, in particular in the reproductive age group. The mean age at diagnosis is 25-29 years, but it is often greater in women who present with infertility rather than pelvic pain. Endometriosis is one of the most common gynaecological diseases, affecting more than 5.5 million women in North America alone. Diagnosing endometriosis may be a dilemma in view of the non-specific nature of the symptoms so that physical examination and the reference standard, laparoscopic exploration, may... Imaging findings OR Procedure details Physiopathology and pathology of endometriosis To understand the MRI signal characteristic of endometriosis, it is important to remember that these nodules, like the intrauterine endometrium, are subject to hormonal variations and therefore present chronic bleeding. The T1 hyper intensity corresponds to the signal of the sub-acute hemorrhagic lesions whereas the low T2 and intermediate-to-low T1 signal to the fibrous stroma. The presence of a hemorrhagic nodule is a very specific finding for endometriosis but it is associated to low sensitivity because nodules may be not...

MRI is sensitive method to identify endometriosis and enables complete lesion mapping before surgery. Posterior locations usually demonstrate abnormal T1 and T2-hypointense, nodules with occasional T1-hyperintense spots. Deep pelvic endometriosis is easier to identify when peristaltic inhibitors and intravenous contrast media are used. In this exhibit we exhaustively described MRI imaging feature suggestive of deep pelvic endometriosis.

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