Postoperative Imaging of Endometriosis

Glaucy Lane Neme, Cassia T. S. Guimarães, Patricia Perola Dantas, Santana DDB, Daniel D. B. Santana, Fernando Ide Yamauchi, Hilton Muniz Leão Filho, Leonardo Kayat Bittencourt, Ricardo M. A. Pereira, Mattos La, Leandro A Mattos, Leandro Accardo de Mattos
Radiographics : a review publication of the Radiological Society of North America, Inc · 2024 · vol. 44(4) , pp. e230159 · doi:10.1148/rg.230159 · PMID:38512726 · W4393033397
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This paper discusses the imaging aspects of postoperative endometriosis, emphasizing the approach, surgical techniques, expected findings, complications, and analysis of residual disease or recurrence.

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Abstract

Endometriosis is a highly prevalent disease that affects 10%-15% of women of reproductive age worldwide and is mainly associated with chronic pelvic pain and infertility. With the widespread use of imaging for the diagnosis and monitoring of endometriosis, combined with the ability of surgery to eradicate the disease and address infertility, there has been a significant increase in recent years in imaging examinations for postoperative evaluation of endometriosis. US and MRI are used not only to help diagnose and map endometriosis but also to evaluate refractory symptoms, residual lesions, and complications at posttreatment assessment. Knowledge of surgical techniques and recognition of expected postoperative imaging findings are crucial to differentiate postoperative changes from residual disease and/or recurrence. The authors discuss imaging aspects of postoperative endometriosis, with an emphasis on the imaging approach, comprehension of surgical techniques, recognition of the expected findings, possible complications, and analysis of residual disease or recurrence. ©RSNA, 2024 Test Your Knowledge questions for this article are available in the supplemental material. See the invited commentary by VanBuren in this issue. The slide presentation from the RSNA Annual Meeting is available for this article.
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Abstract

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Introduction

Imaging Approach General Considerations Patient Preparation MRI Technique US Technique General Postoperative Imaging Aspects Valid for All Sites Surgical Options and Specific Postoperative Imaging Aspects Retrocervical Space and Posterior Cul-De-Sac Vagina Bowel Ovaries Uterus Bladder and Vesicouterine Peritoneum Ureter Diaphragm Canal of Nuck and Abdominal Wall Recurrence versus Residual Endometriosis after Surgery Postoperative Complications

Conclusion

Acknowledgment Footnotes Supplementary Material Test Your Knowledge Questions Test Your Knowledge questions for this article are provided below as supplemental material. Please claim CME credit in the Online Learning Center. - Deep endometriosis (DE) in a 29-year-old woman 6 months after surgery. Coronal (A) and axial (B) T2-weighted MR images show fibrotic scars (yellow arrow) in the left paracervix and pararectal spaces, and loculated fluid (green arrow) in the right pararectal space. What endometriotic site(s) are commonly associated with these postoperative findings? - Ileum and appendix. - Retrocervical and posterior cul-de sac. - Bladder and vesicouterine peritoneum. - Vagina. - According to the findings on the coronal T2-weighted (A) and axial T1-weighted in-phase (B) MR images, what surgical technique for deep infiltrating endometriosis of the bowel was performed? - Rectal shaving. - Discoid resection. - Sleeve resection. - Segmental resection. Answer key: 1. b 2. d Supplemental Table Supplemental Figures

References

Information & Authors Information Published In Abbreviations - DE - deep endometriosis - LP - laparoscopy - 3D - three dimensional Copyright History Authors Disclosures of conflicts of interest.— Metrics & Citations Metrics Article Usage Altmetrics Citations Export citation Select the format you want to export the citation of this publication. Cited by View Options To read the full-text, please use one of the options below to sign in or purchase access. RSNA members have free access to all RadioGraphics content. However, complimentary journal-based CME activities are only included for members with the Standard or Full Access packages. RSNA Journals participate in the World Health Organization's Research4Life program and the online versions of the journals are either freely available or are available with low-cost access to not-for-profit institutions in eligible countries. Login options Check if you have access through your login credentials or your institution to get full access on this article. Purchase Options Subscribe and get full access to this article. Recommend this journal to your librarian To read the full-text, please use one of the options below to sign in or purchase access. RSNA members have free access to all RadioGraphics content. However, complimentary journal-based CME activities are only included for members with the Standard or Full Access packages. RSNA Journals participate in the World Health Organization's Research4Life program and the online versions of the journals are either freely available or are available with low-cost access to not-for-profit institutions in eligible countries. Recommend to a librarian Recommend this journal to your librarian Redeem Voucher Access tokens allow you to activate and access content online. If you have been issued an access token, please enter it here and click 'Submit':

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Condition tags

endometriosischronic_pelvic_paininfertility

MeSH descriptors

Endometriosis Endometriosis Endometriosis Endometriosis Endometriosis Endometriosis Endometriosis Endometriosis Endometriosis Endometriosis Endometriosis Endometriosis Endometriosis Endometriosis Endometriosis Endometriosis Endometriosis Endometriosis Endometriosis Endometriosis

Citation neighborhood

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.

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