Ultrasonography and CT Findings of Abdominal Wall Endometrioma

Sang Ho Kim, Hee Gon Kim, Wei Chian Liu, Kyo Nam Kim, Sook Wook Kang, Soo Ah Kim, Keun Eur, S Y Baek, Hee Jin Kim, Jae Bock Chung, Yoo Mi Kang
In: Journal of the Korean Radiological Society · 1999 · vol. 40(2) , pp. 289 · doi:10.3348/jkrs.1999.40.2.289 · W2345480552
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This study evaluated ultrasound and CT characteristics of abdominal wall endometriomas in nine patients with prior cesarean sections, identifying specific imaging features such as low-echoic masses and spiculated margins to aid diagnosis.

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This study evaluated the ultrasonography and computed tomography characteristics of abdominal wall endometriomas in nine patients, all of whom had a history of cesarean section. The authors analyzed imaging features such as location, size, shape, and enhancement patterns, noting that masses ranged from 2 to 4.5 cm and were found in either subcutaneous or muscle layers. Key diagnostic indicators included low-echoic masses with irregular margins on ultrasound and spiculated margins or strong enhancement on CT scans, particularly when associated with cyclic pain. This paper is centrally about endometriosis — specifically the radiological diagnosis of abdominal wall endometrioma, a rare extrapelvic manifestation of the disease.

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Abstract

PURPOSE: To evaluate the US and CT findings of abdominal wall endometrioma. MATERIALS AND METHODS: We respectively reviewed nine patients with abdominal wall masses diagnosed as endometrioma during a recent three-year period. Both US and CT scans were performed in six cases, only ultrasound in one, and only CT scans in two. The location, size, shape, margin, internal echo or density, enhancement patterns, and relation to adjacent masses, as seen on US and CT images, were reviewed. RESULTS: All patients had a previous history of deliveries by caesarian section. All masses were 2-4.5cm in size ; five were located in subcutaneous layers and four in musclel ayers. In all cases, sonographic findings were low echoic masses with irregular margins(7/7). Internal echotextures were inhomogeneous in five cases and homogeneous in two. On CT, masses in subcutaneous layers(5/8)showed spiculated margins and linear enhancement of the rectus muscle fascia. In cases of lesion located in muscle(3/8), slight thickening of the rectus muscle was visible on precontrast CT scans, but on postcontrast CT scans, well-defined enhancing masses, separate from the rectus muscle were seen. CONCLUSION: When patients with a previous history of caesarian section present palpable abdominal wall masses, with cyclic pain, sonographic findings of a low echoic mass separated from the internal organs, and CT findings of a strongly enhanced mass are useful for the diagnosis of endometrioma.
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Published online Mar 14, 2016. https://doi.org/10.3348/jkrs.1999.40.2.289 Ultrasonography and CT Findings of Abdominal Wall Endometrioma Abstract PURPOSE: To evaluate the US and CT findings of abdominal wall endometrioma. MATERIALS AND METHODS: We respectively reviewed nine patients with abdominal wall masses diagnosed as endometrioma during a recent three-year period. Both US and CT scans were performed in six cases, only ultrasound in one, and only CT scans in two. The location, size, shape, margin, internal echo or density, enhancement patterns, and relation to adjacent masses, as seen on US and CT images, were reviewed. RESULTS: All patients had a previous history of deliveries by caesarian section. All masses were 2-4.5cm in size ; five were located in subcutaneous layers and four in musclel ayers. In all cases, sonographic findings were low echoic masses with irregular margins(7/7). Internal echotextures were inhomogeneous in five cases and homogeneous in two. On CT, masses in subcutaneous layers(5/8)showed spiculated margins and linear enhancement of the rectus muscle fascia. In cases of lesion located in muscle(3/8), slight thickening of the rectus muscle was visible on precontrast CT scans, but on postcontrast CT scans, well-defined enhancing masses, separate from the rectus muscle were seen. CONCLUSION: When patients with a previous history of caesarian section present palpable abdominal wall masses, with cyclic pain, sonographic findings of a low echoic mass separated from the internal organs, and CT findings of a strongly enhanced mass are useful for the diagnosis of endometrioma.

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