Anterior pelvic endometriosis: MRI features

Novellas, S.; Chassang, Madleen; Bouaziz, Jérôme; Delotte, J.; Toullalan, Olivier; Chevallier, et P

doi:10.1007/s00261-010-9600-1

Cited by 29 publications

(28 citation statements)

References 35 publications

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“…Endometriosis of the ureter usually stems from endometriosis of the pelvic foci and ovarian endometriosis [41,42]. Extrinsic and intrinsic endometriosis are involved in the ureters: extrinsic represents 75-80% of cases, and is defined as the presence of endometrial tissue in the outer adventitia of the ureter.…”

Section: Deep Infiltrating Endometriosis Diagnostic Imaging and Implimentioning

confidence: 99%

Imaging for the evaluation of endometriosis and adenomyosis

Exacoustòs

Manganaro

Zupi

2014

Best Practice & Research Clinical Obstetrics & Gynaecol

207

143

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Endometriosis affects between 5 and 45% of women in reproductive age, is associated with significant morbidity, and constitutes a major public health concern. The correct diagnosis is fundamental in defining the best treatment strategy for endometriosis. Therefore, non-invasive methods are required to obtain accurate diagnoses of the location and extent of endometriotic lesions. Transvaginal sonography and magnetic resonance imaging are used most frequently to identify and characterise lesions in endometriosis. Subjective impression by an experienced sonologist for identifying endometriomas by ultrasound showed a high accuracy. Adhesions can be evaluated by real-time dynamic transvaginal sonography, using the sliding sign technique, to determine whether the uterus and ovaries glide freely over the posterior and anterior organs and tissues. Diagnosis is difficult when ovarian endometriomas are absent and endometriosis causes adhesions and deep infiltrating nodules in the pelvic organs. Magnetic resonance imaging seems to be useful in diagnosing all locations of endometriosis, and its diagnostic accuracy is similar to those obtained using ultrasound. Transvaginal ultrasound has been proposed as first line-line imaging technique because it is well accepted and widely available. The main limitation of ultrasound concerns lesions located above the rectosigmoid junction owing to the limited field-of-view of the transvaginal approach and low accuracy in detecting upper bowel lesions by transabdominal ultrasound. A detailed non-invasive diagnosis of the extension in the pelvis of endometriosis can facilitate the choice of a safe and adequate surgical or medical treatment

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Section: Deep Infiltrating Endometriosis Diagnostic Imaging and Implimentioning

confidence: 99%

Imaging for the evaluation of endometriosis and adenomyosis

Exacoustòs

Manganaro

Zupi

2014

Best Practice & Research Clinical Obstetrics & Gynaecol

207

143

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“…The rare intrinsic ureteral involvement occurs when ectopic endometriosis tissue is present in the mucosal or muscular layer of ureters, from deep infiltrating periureteral lesion or, hypothetically, from lymphatic or venous metastases (1, 3). The majority of the localizations occur in the tract of the ureter within the pelvis; they are often unilateral (80% of the patients) and more common on the left side (1,25). Clinical diagnosis is very difficult because symptoms, such as renal colic, lumbago, or hematuria, are nonspecific.…”

Section: Epidemiology and Clinical Characteristicsmentioning

confidence: 99%

“…They normally show fibrous signal on both T1-and T2-weighted sequences. Affected ligament appears thickened, usually more than 1 cm, shortened, and irregular, with nodular aspect on T2-weighted sequences (1,19). The signal could be various, depending on the presence of stromal tissue, glandular elements, hemorrhage, inflammatory reaction, or fibrous tissue.…”

Section: Round Ligamentmentioning

confidence: 99%

“…3, 4). A mixture of these two components, namely, fibrous tissue with low signal intensity on T1-weighted imaging and small hemorrhagic foci depicted as hyperintense signal on T1-weighted imaging are the most frequent lesions (1,19,20). The detection of free fluid around the RLUs on ''antideclive position'' might be an indirect sign of endometriosis of the intrapelvic portion of the RLUs (21).…”

Section: Round Ligamentmentioning

confidence: 99%

“…Epidemiology and clinical characteristics: Incidence of endometriosis of the round ligaments of the uterus (RLUs) is between 0.3% and 14% (1,19,20). RLUs have an intrapelvic and an extrapelvic portion where the extrapelvic one is the distal part of the ligament in the canal of Nuck (1).…”

Section: Round Ligamentmentioning

confidence: 99%

See 2 more Smart Citations

Shining light in a dark landscape: MRI evaluation of unusual localization of endometriosis

Gui¹,

Valentini²,

Ninivaggi³

et al. 2017

Diagn Interv Radiol

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Endometriosis is a systemic disease that affects about 10% to 20% of women during their reproductive age, characterized by the presence of endometrial glands and stroma outside the uterine cavity (1). Endometriosis lesions are characterized by intralesional recurrent bleeding during menses, because of the hormonal responsiveness of ectopic endometrial tissue, with resulting fibrosis. Typical symptoms are cyclic or chronic pelvic pain, dysmenorrhea, dyspareunia, and pain during defecation or urinating. Unusual endometriosis localizations may be associated with more specific symptoms depending on the site of the localization. According to Siegelmen et al. (2) there are three forms of pelvic endometriosis: (a) superficial peritoneal lesions; (b) ovarian endometrioma; (c) deep (or solid infiltrating) endometriosis (DIE), which is histologically identified as a lesion that extends more than 5 mm into the subperitoneal space and/or affects the wall of organs in the pelvis and ligaments. In superficial endometriosis, superficial plaques are disseminated across the peritoneum, adnexa and ligaments of the uterus; these noninvasive implants are well recognized at laparoscopy and not often detectable with magnetic resonance imaging (MRI). Laparoscopy is the standard of reference for the diagnosis of endometriosis but nodules covered by adhesions and subperitoneal disease are difficult to study. Pouch of Douglas, uterosacral ligaments, torus uterinus, and bowel are the most frequent sites of deep pelvic endometriosis localization. Atypical pelvic localizations of endometriosis can occur at level of the cervix, vagina, round ligaments, ureter, and nerves. Rare extrapelvic endometriosis implants can also be localized in the upper abdomen, subphrenic fold, or subcutaneous fat tissue of the abdominal wall. The focus of this review is to describe atypical pelvic and abdominal localizations of endometriosis that should be known by radiologists in order to correctly identify and characterize these lesions on MRI. Moreover, we describe the MRI appearance of the implants at specific sites and review the literature with special attention to imaging reports and description. 272From the Institute of Radiology, Diagnostic Area (B.G.  benedetta.gui@policlinicogemelli.it, A.L.V., V.N., M.M., V.Z., P.P.G., F.C., L.B.) and the Institute of Obstetrics and Gynecology, Female Health Area (M.G.), Catholic University of the Sacred Heart, Agostino Gemelli Hospital, Rome, Italy; "F. Miulli" Regional General Hospital (M.G.), Acquaviva delle Fonti, Bari, Italy. ABSTRACTEndometriosis is a disease distinguished by the presence of endometrial tissue outside the uterine cavity with intralesional recurrent bleeding and resulting fibrosis. The most common locations for endometriosis are the ovaries, pelvic peritoneum, uterosacral ligaments, and torus uterinus. Typical symptoms are secondary dysmenorrhea and cyclic or chronic pelvic pain. Unusual sites of endometriosis may be associated with specific symptoms depending on the localization. Atypical pelv...

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Endometriosis

Schreiter¹,

Kinkel²

2017

MRI and CT of the Female Pelvis

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Anterior pelvic endometriosis: MRI features

Cited by 29 publications

References 35 publications

Imaging for the evaluation of endometriosis and adenomyosis

Imaging for the evaluation of endometriosis and adenomyosis

Shining light in a dark landscape: MRI evaluation of unusual localization of endometriosis

Endometriosis

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