A pictorial review of pelvic endometriosis in MRI

Pelvis, Abdomen, Anatomy, MR, Diagnostic procedure, Surgery, Pathology, Cysts Authors: M. A. Haouari1, O. Ghdes1, I. Kasraoui2, A. Ali1, I. Naccache1, A. Ben Miled1, N. Mnif1; 1Tunis/TN, 2BIZERTA, BI/TN DOI: 10.1594/ecr2017/C-2230 Learning objectives The purpose of this Educational Exhibit is to: Indicate the MRI protocol performed in the exploration of pelvic endometriosis. Review the MRI findings in pelvic endometriosis and illustrate its different aspects in its various pelvic locations using a compartmental subdivision of the pelvis.

Endometriosis is a common chronic condition that occurs in women of childbearing age. It’s defined as ectopic endometrial tissue outside the uterine cavity. It usually causes debilitating abdominal pain and may be responsible of infertility. The reference examination for diagnostic confirmation of the pelvic endometriosis is the histological examination of samples provided by laparoscopic biopsy. MRI is the imaging test of choice in pelvic endometriosis. It allows the detection of this pathology and allows precise lesion cartography, which is the only guarantee of a complete... Findings and procedure details Patients were referred to us by gynecologists for suspected pelvic endometriosis. They have been explored by pelvic MRI. This allowed us to make the diagnosis of endometrioma, adenomyosis, superficial and deep pelvic endometriosis. These MRI allowed us to illustrate the different locations of pelvic endometriosis. 1. MR protocol: It is preferable to perform the MRI during a painful period at the beginning of the cycle, due to the hemorrhagic nature of the endometriosis lesions. The use of antiperistaltic medication is useful to limit digestive artefacts...

The use of MRI is validated in the assessment of deep endometriosic implants. The subdivision of the feminine pelvis into compartments facilitates lesion analysis and mapping of the deep pelvic endometriosis.

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