Deep endometriosis (DE) postoperative chances in Magnectic Ressonance (MR)

Tissue characterisation, Surgery, Complications, MR, Pelvis, Genital / Reproductive system female Authors: A. C. C. BRANDAO1, P. P. Ianez2, R. V. Leao2, A. O. Silva2, C. P. Crispi2, M. A. P. Oliveira2; 1rio de janeiro, RJ/BR, 2Rio de Janeiro/BR DOI: 10.1594/ecr2012/C-2300 Learning objectives MR is a noninvasive method with high spatial resolution, that allows tissue characterization of DE, facilitating diagnosis and presurgical counseling. MR is being usedinDEpostoperative evaluation, howeverthere are noreports in the literatureon this subject with this method. Thisarticle aims toshow the mainpost-operative chances and complications of DE. A retrospectivereview study was done at our institutionwith 7000 MR between 2007 to 2011. 30patients were selected with pre and postoperative MR. To illustrate the findings of postoperative changes of deep endometriosis we show two cases. Firsts pre and...

DE is an important disorder, responsible for severe pelvic pain, defined as subperitoneal invasion 5 mm under peritoneum, affecting vital structures. Laparoscopy is gold standart for treatment andis carried out worldwide by numerous surgical teams.Postoperative changes and complications are related to each surgical strategy, and are more common inpatients carrying out complex and difficult surgical procedures, such as rectal endometriosis removal. After surgery patients maypresentpelvic pain, that can be unrelated torecurrence orresidual lesion. Unfortunally recorrence can occur and there is low correlationbetween pain andclinical recurrence.... Imaging findings OR Procedure details The MR post-surgicalchanges observed in our 30 patients were: 1.Ligament andparietalperitoneum resection- thin tissue, hypointenseonT2, well defined, with no bleeding . Aderence can be seen. (Figures 1-6,9,10) 2.Parametrium changes. Lesion resection may include parametrium (Figure 15 - parametrium laparoscopic resection). Magnetic resonance (figures 16 e 17 with T2 weighted images) shows no left parametrium, ressection of superior left vagina, reduction of cervix miometrium until stromal zone with fibrocicatricial changes at this location and paracolpos. Note adherence with sigmoide. Figure 18- Coronal T2 weighted preoperative magnetic...

Interpretation at this paper was always correlated with previousMRIandsurgical reports, as well patient postoperative complain. Those, togheter with high level of pelvic anatomic knowledge, helped to identify postsurgical changes and distinguish of recurrence. Radiologists should be familiar with MRpost-surgicalchances, to distinguish from recurrence. Personal Information Alice Brandão Radiologist specialized in women's MR imaging. Clínica Felippe Mattoso e IRM - Magnetic Resonance. Printed two books: Gynecology and Obstetric Magnetic Resonanc (2002) and Breast Magnetic Resonance (2010), both edited by Revinter. Mail: [email protected] Renata Carneiro Leão Radiologist specialized in MR imaging. Clínica Felippe Mattoso e IRM - Magnetic Resonance. Mail: [email protected] Paula Pavão Ianez Radiologist specialized in MR imaging. Clínica Felippe Mattoso e IRM - Magnetic Resonance. Mail: [email protected] Cláudio Peixoto Crispi General Coordinator of the graduate videoendoscopy gincológica IFF-FIOCRUZ. Assistant Professor,...

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