Magnetic resonance imaging characteristics of polypoid endometriosis and review of the literature

Mayumi Takeuchi, Kenji Matsuzaki, Yoshimi Bando, Masafumi Harada
Journal of Obstetrics and Gynaecology Research · 2022 · vol. 48(10) , pp. 2583–2593 · doi:10.1111/jog.15367 · PMID:35868869 · W4286671878
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⚙ AI-generated summary by claude@2026-06, 2026-06-10 ⓘ

This study evaluated MR imaging characteristics of four polypoid endometriosis cases, finding the black rim sign, no diffusion restriction, and gradual contrast enhancement may help differentiate it from malignancy.

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Abstract

AIM: Polypoid endometriosis is a rare variant of endometriosis and may mimic malignancy. The purpose of this study is to evaluate magnetic resonance (MR) imaging characteristics of polypoid endometriosis for the differential diagnosis with malignancy. METHODS: MR imaging findings of four histologically proven polypoid endometriosis were retrospectively evaluated with the review of the literature. RESULTS: All polypoid endometriosis exhibited high signal intensity on T2-weighted images reflecting abundant dilated endometrial glands. Peritoneal lesions were surrounded by low signal intensity rim represented the "black rim sign" reflecting endometriotic fibrous adhesion. Two cases arising from endometriotic cysts showed transmural extension (peritoneal extension and myometrial infiltration). Endometriotic hemorrhagic foci were demonstrated in four lesions as high signal intensity on T1-weighted images and/or susceptibility-induced signal voids on susceptibility-weighted MR sequence. Diffusion-weighted images showed high signal intensity with relatively high apparent diffusion coefficient (ADC) due to T2 shine-through effect but no diffusion restriction, and dynamic contrast-enhanced (DCE) MR imaging showed gradually increasing contrast-enhancement pattern like benign pathologies. CONCLUSIONS: Polypoid endometriosis may mimic malignancy; however, black rim sign may be a characteristic MR imaging finding for the peritoneal lesions, and no diffusion restriction and gradually increasing contrast-enhancement pattern may reflect its benign nature.

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Condition tags

endometriosis

MeSH descriptors

Endometriosis Endometriosis Endometriosis Endometriosis Endometriosis Endometriosis Peritoneal Diseases Peritoneal Diseases Peritoneal Diseases Peritoneal Diseases Peritoneal Diseases Peritoneal Diseases Polyps Polyps Polyps Polyps Polyps Polyps Diagnosis, Differential Diagnosis, Differential

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Papers in the corpus that this work cites (lower rings, blue) and that cite this one (upper rings, green). Dot size scales with the paper's in-corpus citation count — bigger dot = more influential within the endo/adeno field. Click a dot to open that paper. [ expand to 2 hops ] — adds papers reached through this work's immediate citers/citees. Heavier; up to 60 extra dots.

References (23)

Cited by (7)

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