Endometriosis :Less common sites of involvement and complications

Performed at one institution, Not applicable, Obstruction / Occlusion, Obstetrics, Cancer, Education, Diagnostic procedure, Complications, MR, CT, Pelvis, Genital / Reproductive system female, Genitourinary Authors: J. K. Hadchiti1, A. Obeid2, A. FECHNER3, J. Delaveaucoupet3, L. Rocher1; 1clamart/FR, 2Poissy/FR, 3Paris/FR DOI: 10.26044/ecr2020/C-02106 Learning objectives Describe the imaging appearance of unusual complications of endometriosis and less common sites of involvement. Illustrate cases of these less common complications and sites of involvement from our institution. Show the importance of MRI in detection and characterization of endometriosis.

Definition: Endometriosis is characterized bythe presence of ectopic endometrial tissue outside the uterine cavity, affecting 10% of female of reproductive age [1]. Etiology of endometriosis It is a multifactorial disease [2] , with several potential mechanisms being discussed (Fig 2) :(a)Retrograde menstruation through the fallopian tubes.(b-c) Lymphatic and hematogeneous spread and(d) Coelomic metaplasia. There are Two forms of endometriosis[1]: •Superficial endometriosis. Deep pelvic endometriosis(Fig3)involving the anterior(Fig4), middle(Fig 5) and posterior(Fig 6) compartments of the pelvis. Clinical manifestations : Deep endometriosis is associated with cyclic/chronic pelvic... Findings and procedure details •12% of women with pelvic endometriosis present with extra genital/extrapelvic locations [3] •In this pictorial review, we present unusual complications of endometriosis and less common sites of involvement from our institution on a1.5 T imager #Case 1:Decidualization of endometrioma (Fig 7) 34 years old pregnant female(20 weeks GA) with left ovary decidualization mimicking ovarian neoplasm. Teaching point: Levels of progesterone are increased during pregnancy leading to stromal cells proliferation in the endometrium of the gravid uterus but this process can occur in the endometrial tissue...

This pictorial review highlights the imaging findings of endometriosis complications and less common sites of involvement with special attention to the importance of MRI which helps diagnosis and plan surgical strategy and the surgical approach . After reading this review, residents and radiologists should consider the wide range of localizations of endometriosis and should have improved their skills in diagnosing and reporting the disease. Personal information and conflict of interest J. K. Hadchiti; Clamart/FR - nothing to disclose J. Delaveaucoupet; Paris/FR - nothing to disclose A. Fechner; Paris/FR - nothing to disclose A.Obeid;Paris/FR-nothing to disclose L.Rocher;Paris/FR-nothing to disclose

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