Interactive Transcript
0:01
Now this is a really important slide
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because it breaks down the different
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pelvic compartments for the radiologist.
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And I find this a very useful approach when
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I'm interpreting these MRI cases because,
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you know, if you're just looking for the
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ovary or you're just looking, you know,
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generally at the pelvic organs, you might
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forget to look in certain areas where
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endometriotic deposits can be hidden.
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So, um, this color-coded diagram just goes
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through the spaces in the pelvis and the dotted
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lines here just show you the breakdown between
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the anterior compartment, which is anterior
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to the dashed line, the posterior compartment,
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which is posterior to this dotted line, and
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in between, which is really the, the uterus.
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The cervix and the vagina, which is
0:48
the middle compartment of the uterus.
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So the ovaries and fallopian tubes are also
0:52
considered part of the middle compartment.
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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
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The patterns of endometriosis, which I like
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to break down into three main categories.
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So the first category is the ovarian
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deposit, which we know as the endometrioma.
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So this is an ovarian mass with
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ground glass or low-level echoes.
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And then we've got superficial
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peritoneal lesions, which cause
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fibrosis, scarring, and hemorrhage.
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And these usually are recognized at laparoscopy.
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And one common manifestation is kissing ovaries.
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And we'll talk about that in just a moment.
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And then finally, we've got the deep, solid,
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and infiltrating type, which happens when
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endometrial glands burrow deep below the
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peritoneal surface by five millimeters or more.
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So those can be very difficult
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to detect by the laparoscopist.
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And that's where MRI really has a role to
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play because we might be able to see them even
2:01
though they're not visible to the laparoscopist.
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And these are likely the biggest culprit
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of pain and infertility, which are commonly
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experienced by patients with endometriosis.
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So once you think about endometriosis with those
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three approaches, it's a little bit easier to
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look for all of those manifestations on MRI.
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And now we're going to go through
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each of those three patterns.
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