Staging of pelvic endometriosis

Cysts, Colonography MR, MR, Pelvis, Genital / Reproductive system female, Abdomen Authors: B. Turi, M. R. Fracella; Bari/IT DOI: 10.1594/ecr2014/C-2037 Aims and objectives Endometriosis is a common gynecological disorder defined by the presence of ectopic endometrial glands and stroma outside the uterus. it represents a common and very important clinical ploblem in women of chilbearing age, manifesting with pain and infertility. The most common locations nof endometriosis are ovaries and pelvic peritoneum, followed by deep lesions of the pelvic subperitoneal space, the intestinal system and the urinary system. Deeeply infiltrating endometriosis is a specific entity: deep endometriotic lesions penetrate under the surface of peritoneum (infiltration >5 m, in...

and materials Since December 2011 until August 2013 we enrolled 67 patients, age within 31and 38 years, all with sympom cronic pelvic pain, 35 with story of endometriosis (12 submitted to ovarictomy and salpingectomy for endometriosis; 8 submitted to appendicectomy; 2submitted to colecistectomy); 19 with hight suspicion and 13 with medium-low suspicion ofendometriosis. MR images were acquired with 1.5 T and phase array coil with standard sequences (T1,T2) in every cases; in 28 cases with suspicion of bowel localization of endometriosis we used ColografiaRM (controlled distention of...

In 48 of 67 patients we found: -15 cases: ovarian endometrioma; -11 cases: bowel endometriosis; -7 cases: obliteration of Douglas; -3 cases: endometriosis nodules of bladder; -12 cases: nodules, fibrosis and adherences. The colografiaRM allowed to identify 15 ovarian endometriomas, 32 bowel localization (single or multiple), allowing differential diagnosis between endometriosis nodules and fibrosis in 12 cases. The meeting between RM and laparoscopy has been 92%.

Laparoscopy remains the gold standard for the diagnosis and staging evaluation. Deep pelvic endometrisis is a common disease affecting women of chilbearing age. The deep endometriotic implants entice an intense desmoplastic response in the surrounding soft tissues, leading to the formation of adhesions, fibrotic plaque and bands resulting in a ''frozen pelvic'', that can severely limit the yield of laparoscopy. Therefore accurate preoperative imaging is invaluable for adequate patient management and treatment planning. MRI is a useful noninvasive imaging modality. Its multiplanar capabilities and superior... Personal information Ospedale San Paolo ASL BARI UOC di Radiologia Direttore Dott.ssa Antonietta Ancona

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