Imaging of Endometriosis-Related Pain

In: Pain Imaging · 2019 · pp. 471–485 · doi:10.1007/978-3-319-99822-0_23 · W2921639770
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This chapter details diagnostic imaging tools for endometriosis, focusing on MRI and ultrasound to identify endometriomas, peritoneal, and deep infiltrating implants, and recent MRI techniques for neural involvement.

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This chapter reviews diagnostic imaging tools for endometriosis, emphasizing epidemiologic and mechanistic ideas about pain generation and detailing MRI as a second-level modality after transvaginal ultrasound (TVUS). It describes MRI protocols and characteristic imaging features of the main endometriosis forms (endometrioma, peritoneal endometriosis, and deep infiltrating implants) and also briefly surveys newer MRI techniques aimed at evaluating neural involvement in severe endometriosis-related pain. A stated limitation is that the chapter provides an illustrative overview of diagnostic tools rather than presenting new patient data or a unified comparative accuracy analysis. This paper is centrally about endometriosis — it focuses on MRI (and its relation to TVUS) for diagnosing and assessing endometriosis-related pain, including neural involvement.

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Abstract

This chapter aims at illustrating the diagnostic tools currently used for the diagnosis of endometriosis. A paragraph will focus on epidemiology and theories proposed to explain the genesis of pain. We will discuss the role of Magnetic Resonance Imaging, as the second level imaging modality. MRI application in endometriosis will follow the section regarding TVUS; we will discuss protocol and MRI features of endometriosis. We will go through the three main forms of endometriosis, endometrioma, peritoneal endometriosis, and deep infiltrating implants, showing their appearance in the two imaging modalities. At last a brief paragraph will show MRI techniques recently applied to directly evaluate the neural involvement in case of severe endometriosis related pain. Access this chapter Tax calculation will be finalised at checkout Purchases are for personal use only Similar content being viewed by others

References

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Author information Authors and Affiliations Corresponding author Editor information Editors and Affiliations 23.1 Electronic Supplementary Material Endometrioma of the right ovary (MOV 39347 kb) Endometrioma of the right ovary (MOV 6363 kb) Endometrioma of the left ovary with typical “shading sign” (MOV 6678 kb) Endometrioma of the left ovary with typical “shading sign” (MOV 13607 kb) Tubal and ovarian endometriosis with hematosalpinx (MOV 6621 kb) Tubal and ovarian endometriosis with hematosalpinx (MOV 19071 kb) Tubal and ovarian endometriosis with hematosalpinx (MOV 7124 kb) Deep infiltrating endometriosis of posterior compartment with rectal wall infiltration, adenomyosis and ovarian endometriosis (MOV 9905 kb) Deep infiltrating endometriosis of posterior compartment with rectal wall infiltration, adenomyosis and ovarian endometriosis (MOV 14576 kb) Deep infiltrating endometriosis of posterior compartment with rectal wall infiltration, adenomyosis and ovarian endometriosis (MOV 6344 kb) Endometriosis of posterior compartment extended to rectum, parametrium and pelvic wall (MOV 10422 kb) Endometriosis of posterior compartment extended to rectum, parametrium and pelvic wall (MOV 5589 kb) Endometriosis of posterior compartment (MOV 13980 kb) Endometriosis of posterior compartment (with and without gel vaginal and rectal filling) (MOV 11327 kb) Endometriosis of posterior compartment (with and without gel vaginal and rectal filling) (MOV 8772 kb) Endometriosis of posterior compartment (with and without gel vaginal and rectal filling) (MOV 20512 kb) Deep infiltrating endometriosis of anterior compartment (nodule in the vesicouterine pouch (MOV 7964 kb) Deep infiltrating endometriosis of posterior and lateral compartments with associated ureteronephrosis; left ovarian endometriosis (MOV 19500 kb) Deep infiltrating endometriosis of posterior and lateral compartments with associated ureteronephrosis; left ovarian endometriosis (MOV 7342 kb) Deep infiltrating endometriosis of posterior and lateral compartments with associated ureteronephrosis; left ovarian endometriosis (MOV 6505 kb) Multifocal deep infiltrating endometriosis with bilateral endometriomas, hematosalpinx and left ureteronephrosis (MOV 9901 kb) Multifocal deep infiltrating endometriosis with bilateral endometriomas, hematosalpinx and left ureteronephrosis (MOV 6972 kb) Adenomyosis, right tubo-ovarian endometriosis, endometriosis of posterior compartment and of peritoneum (MOV 12520 kb) Adenomyosis, right tubo-ovarian endometriosis, endometriosis of posterior compartment and of peritoneum (MOV 13240 kb) Adenomyosis, right tubo-ovarian endometriosis, endometriosis of posterior compartment and of peritoneum (MOV 6265 kb) Adenomyosis, left hematosalpinx, ovarian and peritoneal endometriosis (MOV 15249 kb) Adenomyosis, left hematosalpinx, ovarian and peritoneal endometriosis (MOV 7074 kb) Adenomyosis, left hematosalpinx, ovarian and peritoneal endometriosis (MOV 5011 kb) Adenomyoma (MOV 6222 kb) Adenomyoma (MOV 11131 kb) Endometriosis of posterior compartment with infiltration of right puborectalis muscle and ipsilateral sacral nerval roots (MOV 13366 kb) Endometriosis of posterior compartment with infiltration of right puborectalis muscle and ipsilateral sacral nerval roots (MOV 6881 kb) Rights and permissions Copyright information © 2019 Springer Nature Switzerland AG About this chapter Cite this chapter Manganaro, L., Vinci, V., Capozza, F., Antonelli, A., Satta, S. (2019). Imaging of Endometriosis-Related Pain. In: Cova, M., Stacul, F. (eds) Pain Imaging. Springer, Cham. https://doi.org/10.1007/978-3-319-99822-0_23 Download citation DOI: https://doi.org/10.1007/978-3-319-99822-0_23 Published: Publisher Name: Springer, Cham Print ISBN: 978-3-319-99821-3 Online ISBN: 978-3-319-99822-0 eBook Packages: MedicineMedicine (R0)

Keywords

- Endometriosis - Pelvic pain - Endometrioma - Adenomyosis - Adenomyoma - Adhesions - Fibro endometriosis - Deep endometriosis - Infiltrating endometriosis - Hematosalpinx - Peritoneal endometriosis - Vaginal endometriosis - Bowel endometriosis - Bladder endometriosis - Pelvic tractography - Endometriotic nodule - Pouch of Douglas endometriosis - Imaging - MRI - Trans vaginal US

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