Endometriosis- Cut to the Facts

Genital / Reproductive system female, MR, Education, Education and training Authors: L. Corkery, J. Sammon DOI: 10.26044/ecr2025/C-15269 Learning objectives Review typical and atypical radiological appearances of endometriosis focussing on MRI findingsHighlight best approaches to imaging

Endometriosis is the ectopic implantation of endometrial tissue outside of the uterus which affects up to 10% of pre-menopausal females. Three discrete pelvic phenotypes are characterized- Ovarian, Superficial Peritoneal and Deep Pelvic endometriosis.Laparoscopy remains the gold standard investigation for diagnosis. Transvaginal pelvic ultrasound is sensitive for diagnosis of deep pelvic disease. It can detect ovarian endometriomas and nodules which appear as solid, hypoechoic, irregular masses however it is labour intensive and operator dependent. MRI is a superior modality for diagnosis, in particular when there is... Findings and procedure details Significant heterogeneity exists in published literature regarding optimal patient preparation for MRI and appropriate sequences. ESUR guidelines in Pelvic Endometriosis MRI imaging recommend a wide field of view with “Axial 2D-T2W MRI from renal hila to pubic bone, allowing a systematic visualisation of kidneys and potential analysis of the right iliac fossa (i.e. caecum, appendix, small bowel)” Pre medication with an intramuscular anti-spasmolytic such as hyoscine can reduce bowel peristalsis and reduce motion artefact. Our centre does not routinely use vaginal or rectal preparation. At...

Endometriosis is a complex pathology that can lead to debilitating pelvic pain in some patients.Radiologists play an important role in the diagnosis and management of these patients. MRI aids surgical planning in particular with deep lesions, where the approach can be predicted based on morphologic characteristics of lesions and quantitative assessment of lesion including lesion length, thickness and depth of infiltration. This allows patients to be clearly counselled prior to surgery on the extent of surgery needed to remove the disease and to allow planning... Personal information and conflict of interest L. Corkery: Nothing to disclose J. Sammon: Nothing to disclose

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