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[edit] Discussion of Endometriosis

  • Classically defined as the presence of ectopic functional endometrial glands and stroma (outside the uterine cavity).
  • It may vary from microscopic endometriotic implants to large cysts (endometriomas).
  • The most widely accepted theory is that endometriosis results from metastatic implantation from retrograde menstruation.
  • Endometriomas generally occur within the ovaries and are the result of repeated cyclic hemorrhage within a deep implant.

  • Symptoms associated with endometriosis include infertility and pelvic pain.
  • Endometriosis is found in 25%–50% of infertile women
  • 30%–50% of women with endometriosis are infertile.
  • Laparoscopy is the mainstay for diagnosis, staging, and treatment of the disease.

[edit] Imaging Findings for Endometriosis

  • Radiologic evaluation of small endometriotic implants is limited; therefore, the radiologist's role is generally to identify and evaluate endometriomas.

[edit] US

  • Adnexal mass with diffuse low-level internal echoes and absence of particular neoplastic features is highly likely to be an endometrioma if multilocularity or hyperechoic wall foci are present.

[edit] MRI

  • The diagnostic MR imaging findings for ovarian endometriomas are:
    • Adnexal cysts of high signal intensity on both T1- and T2-weighted images or
    • T2 shading: High signal intensity on T1-weighted images and low signal intensity on T2-weighted images (shading). The dense concentration of cyclic hemorrhage and the high viscosity of the contents in the endometrioma cause T2 shortening and produce shading.
  • These adnexal lesions are often multiple.

[edit] Images

Patient #1: Endometrioma

Patient #2: Endometrioma

Patient #3: MR images demonstrate multiple endometriomas

[edit] See Also

[edit] External Links

[edit] References for Endometriosis