Get a Group Membership for your Organization. Free Trial
Pricing
Free TrialLogin

Evaluating Endometriosis

HIDE
PrevNext

0:01

Now this is a really important slide

0:04

because it breaks down the different

0:06

pelvic compartments for the radiologist.

0:08

And I find this a very useful approach when

0:11

I'm interpreting these MRI cases because,

0:14

you know, if you're just looking for the

0:16

ovary or you're just looking, you know,

0:18

generally at the pelvic organs, you might

0:20

forget to look in certain areas where

0:23

endometriotic deposits can be hidden.

0:26

So, um, this color-coded diagram just goes

0:29

through the spaces in the pelvis and the dotted

0:32

lines here just show you the breakdown between

0:35

the anterior compartment, which is anterior

0:37

to the dashed line, the posterior compartment,

0:40

which is posterior to this dotted line, and

0:43

in between, which is really the, the uterus.

0:46

The cervix and the vagina, which is

0:48

the middle compartment of the uterus.

0:50

So the ovaries and fallopian tubes are also

0:52

considered part of the middle compartment.

0:54

And then we've got several anatomic structures

0:56

here, which are outlined for you, which

0:59

are important to be aware of as well.

1:02

And we'll talk about those

1:02

in a little bit more detail.

1:05

I find it very useful too, to think about

1:07

The patterns of endometriosis, which I like

1:10

to break down into three main categories.

1:13

So the first category is the ovarian

1:16

deposit, which we know as the endometrioma.

1:18

So this is an ovarian mass with

1:20

ground glass or low-level echoes.

1:23

And then we've got superficial

1:25

peritoneal lesions, which cause

1:27

fibrosis, scarring, and hemorrhage.

1:29

And these usually are recognized at laparoscopy.

1:33

And one common manifestation is kissing ovaries.

1:36

And we'll talk about that in just a moment.

1:39

And then finally, we've got the deep, solid,

1:42

and infiltrating type, which happens when

1:45

endometrial glands burrow deep below the

1:48

peritoneal surface by five millimeters or more.

1:51

So those can be very difficult

1:53

to detect by the laparoscopist.

1:56

And that's where MRI really has a role to

1:58

play because we might be able to see them even

2:01

though they're not visible to the laparoscopist.

2:04

And these are likely the biggest culprit

2:07

of pain and infertility, which are commonly

2:09

experienced by patients with endometriosis.

2:12

So once you think about endometriosis with those

2:14

three approaches, it's a little bit easier to

2:18

look for all of those manifestations on MRI.

2:21

And now we're going to go through

2:22

each of those three patterns.

Report

Faculty

Zahra Kassam, MD, FRCPC

Associate Professor of Medical Imaging, Division Head of Body Imaging

Western University

Tags

Uterus

Ultrasound

Pelvic Wall and Floor

Ovaries

Non-infectious Inflammatory

Neoplastic

MRI

Idiopathic

Gynecologic (GYN)

CT

Body

© 2024 MRI Online. All Rights Reserved.

Contact UsTerms of UsePrivacy Policy