The clinical importance of Magnetic Resonance Imaging with Diffusion weighted images in diagnosis and treatment planning of endometriosis.

Introduction: Endometriosis is a benign gynecologic disease affecting women of reproductive age. It is defined as the presence of endometrial tissue, glands, and stroma located outside the uterine cavity and associated with fibrosis and inflammatory reaction. It is a polymorphic disease that can manifest as superficial implants on the peritoneal surface; ovarian cysts called endometriomas; or deep lesions that infiltrate the peritoneal surface more than 5 mm, a condition known as deeply infiltrative endometriosis. Patients and Methods: This prospective study wasconducted at the radiology department, Minia university hospital. Our study included twenty three female patients suspected clinically endometriosis with age ranged from (18 to 40) years old and was referred from gynecology and obstetrics department in the period between June 2019 to June 2020 after fulfilling the inclusion criteria. A written consent is taken from all patients after approval of the Medical Ethical Committee of our institution (university). Discussion: Endometriosis is a chronic gynecological pathology that affects females of reproductive age. It is identified as presence of functional endometrial glands outside the uterus. Hormonal changes affect these ectopic tissue and consequently the disease's clinical characteristics. The exact underlying pathogenesis remains unclear, but there are three major theories that could explain the presence of endometrial tissue in ectopic locations; these include retrograde menstruation, celomic metaplasia and lymphatic or vascular metastases with the aid of endocrine and immune factors for the development of the clinical manifestations of the disease. The clinical features of endometriosis are variable; however the most common are chronic pelvic pain and infertility. There are three types of endometriosis: ovarian (endometrioma), superficial, and deep infiltrating.Diagnosis of endometriosis depends mainly on the laparoscopy, with histologic confirmation, however it is an invasive procedure, has a risk of complications and false-negative results, also the complexities regarding to the surgical evaluation of the pelvis, so an increasing literature supporting the value of imaging is increasing, particularly ultrasound and MRI in the diagnosis of ovarian and deep infiltrating endometriosis. This prospective study was conducted at the radiology department, Minia university hospital from June 2019 to June 2020. The study included twenty three female patients suspected clinically for endometriosis with age ranged from 22 to 44 years old and referred from gynecology and obstetrics department.