IRM – avantaje şi limite în diagnosticul şi tratamentul endometriozei

Endometriosis is a common multifocal gynecologic disease that manifests during the reproductive years, often causing chronic pelvic pain and infertility. It may occur as invasive peritoneal fibrotic nodules and adhesions or as ovarian cysts with hemorrhagic content. Although the findings at the physical examination may be suggestive, imaging is ne­ces­sary for the definitive diagnosis, patient counseling and treatment planning. The imaging techniques that are most useful for preoperative disease mapping are trans­va­gi­nal ultrasonography (US) after bowel preparation and mag­ne­tic resonance imaging (MRI). Materials and method. In our retrospective study, associations of MRI diagnoses ver­sus intraoperative diagnoses are statistically significant, with high specificity on rectal lesions (96.8%), respectively 96.2% on sigmoid lesions, then parametrial lesions and rec­to­va­gi­nal septum lesions. The dimensions of the rectal no­dules had a nonparametric distribution (p 0.05) according to the Shapiro-Wilk test. Despite some limitations, magnetic resonance imaging is able to direct­ly demonstrate deep pelvic endometriosis. The MRI feat­ures depend on the type of lesions: infiltrating small im­plants, solid deep lesions mainly located in the posterior cul-de-sac and involving the uterosacral ligaments and torus uterinus, or visceral endometriosis involving the blad­der and rectal wall.