“Urinary tract endometriosis: Detection and evaluation of deep infiltration with MRI”

Urinary Tract / Bladder, MR, Education, Image verification Authors: M. C. Estay, P. Sepulveda, A. Rojas Astorga, A. M. Wilkens, I. A. Maldonado Schoijet, P. Bozzo, J. Gutierrez Chacoff, C. Varela; Santiago/CL DOI: 10.1594/ecr2016/C-1926 Learning objectives In this educational exhibitwe aimed to illustrate MR imaging features of urinary tract endometriosis.

Endometriosis is defined as the presence of ectopic functional endometrial tissue outside the uterine cavity with or without secondary desmoplastic reaction. Is a common cause of pelvic pain and infertility, affecting as many as 10% of premenopausal women. This condition is most prevalent in women 25 to 45 years old (1-5). The definition of deep endometriosis includes rectovaginal lesions as well as infiltrative forms that involve vital structures such as the bowel, ureters, and bladder (1,6). According to the definition of this entity deeply infiltrating... Findings and procedure details We reviewed MRs of patients with endometriosis diagnosed through MR and/or laparoscopy dated 2010-2015. 187 patients were found. A 17% of the patients (n=32) had urinary tract endometriosis. We classified these cases according to the lesion location and associated complications. The bladder and ureters were mostly affected with 75% (n=27) and 22% (n=7) respectively. Only 3% (n=1) had urethral implant. No renal endometriosis was found.

MR imaging demonstrates high sensitivity, specificity, positive and negative predictive values, and accuracy in prediction of the locations and in evaluation of the extension of lesions in patients with this disease. It has been a useful tool to accurately identify and assess the degree of infiltration in urinary tract endometriosis that also complements the evaluation of some secondary complications such as: parietal retraction, lumen bladder deformation, ureteral displacement, hydronephrosis and kidney failure. Personal information María Catalina Estay MD, Department of Radiology, Clínica Dávila, Santiago, Chile. [email protected] Paulina Sepúlveda Pinto MD, Research Fellow in Radiology, Department of Radiology, Clínica Dávila, Santiago, Chile. [email protected] Alberto Rojas Astorga MD, Research Fellow in Radiology, Department of Radiology, Clínica Dávila, Santiago, Chile. [email protected] Ana María Wilkens Romo MD, Radiology Resident, Universidad de los Andes, Department of Radiology, Clínica Dávila, Santiago, Chile [email protected] Ignacio Maldonado Schoijet MD, Department of Radiology, Clínica Dávila, Santiago, Chile. [email protected] Pamela Bozzo MD, Radiology Resident, Universidad de los Andes, Department...

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