Revealing all the secrets of pelvic endometriosis

Genital / Reproductive system female, Pelvis, Peritoneum, MR, Ultrasound, Diagnostic procedure, Screening, Inflammation Authors: A. El Attar, D. Bentaleb, I. El Bekkai, D. Laoudiyi, K. CHBANI, S. Salam DOI: 10.26044/ecr2025/C-17490 Learning objectives To understand the physiopathology of endometriosis and to know the three different entities of this disease. To know the optimal MRI protocol and guidelines for the diagnosis of pelvic endometriosis To describe the imaging characteristics of pelvic endometriosis and its differential diagnosis.

Pelvic endometriosis (PE) is a chronic inflammatory disease that affects 2-8% of females, and more than 80% of affected patients are of reproductive age. It’s considered one of the many causes of pelvic pain and infertility. While the physiopathology of pelvic endometriosis is still not completely understood, different theories have been proposed to explain the disease. Findings and procedure details Endometriosis is the presence of glandular and endometrial stromal tissue outside the uterine cavity. It is mainly found in the abdominal cavity, most commonly on the surface of the ovaries. The most common symptoms are dysmenorrhea, dyspareunia, pelvic pain, and infertility - although it may also be asymptomaticPHYSIOPATHOLOGY Two theories were made trying to explain the physiopathology behind endometriosis (1,2) Retrograde menstruation, reflux of endometrial tissue through the fallopian tube, results in the implantation and growth of endometrial tissue in the peritoneal surface, most found...

Pelvic endometriosis can have a tremendous effect on a patient’s quality of life as well as their fertility. An early and effective diagnosis is mandatory to evaluate the spread of lesions and the severity of adhesions for a more effective treatment strategy. Every radiologist should be familiar with both common and uncommon locations of endometriosis and their characteristic imaging findings. Personal information and conflict of interest A. El Attar: Nothing to disclose D. Bentaleb: Nothing to disclose I. El Bekkai: Nothing to disclose D. Laoudiyi: Nothing to disclose K. Chbani: Nothing to disclose S. Salam: Nothing to disclose

Kido A, Himoto Y, Moribata Y, Kurata Y, Nakamoto Y. MRI in the Diagnosis of Endometriosis and Related Diseases. Korean J Radiol. 2022 Apr;23(4):426–45. Méndez Fernández R, Barrera Ortega J. Magnetic resonance imaging of pelvic endometriosis. Radiologia. 2017 Jul 1;59(4):286–96. Bazot M, Bharwani N, Huchon C, Kinkel K, Cunha TM, Guerra A, et al. European society of urogenital radiology (ESUR) guidelines: MR imaging of pelvic endometriosis. Eur Radiol. 2017 Jul;27(7):2765–75. Rousset P, Florin M, Bharwani N, Touboul C, Monroc M, Golfier F, et al. Deep...