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Endometriosis: radiologic-pathologic correlation.

P J Woodward1, R Sohaey, T P Mezzetti

  • 1Departments of Radiologic Pathology, Armed Forces Institute of Pathology, Bldg 54, Room M-121, Washington, DC 20306-6000, USA. woodwardp@afip.osd.mil

Radiographics : a Review Publication of the Radiological Society of North America, Inc
|February 7, 2001
PubMed
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Endometriosis, a gynecologic disorder, involves uterine lining outside the uterus, causing varied symptoms. Diagnosis relies on imaging like ultrasound and MRI, with laparoscopy as the gold standard.

Area of Science:

  • Gynecology
  • Reproductive Medicine
  • Medical Imaging

Background:

  • Endometriosis is a common gynecologic disorder affecting women of reproductive age.
  • It is characterized by the presence of endometrial tissue outside the uterus.
  • Manifestations range from microscopic implants to large endometriomas, with symptoms varying widely.

Purpose of the Study:

  • To review the pathological features, clinical manifestations, and diagnostic modalities of endometriosis.
  • To highlight the role of imaging techniques in endometriosis diagnosis.
  • To discuss the diagnostic limitations and the gold standard for staging.

Main Methods:

  • Review of ultrasonography (US) and magnetic resonance imaging (MRI) features of endometriosis.
  • Discussion of the diagnostic accuracy of different imaging modalities.

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  • Emphasis on laparoscopy as the definitive diagnostic and staging tool.

    • Main Results:

    • Endometriomas exhibit specific US features like low-level internal echoes and echogenic wall foci.
    • MRI shows endometriotic cysts with high T1 signal intensity and T2 "shading".
    • Ovaries are most commonly affected, but endometriosis can occur in other sites.

    Conclusions:

    • Imaging findings can suggest endometriosis but may mimic other ovarian lesions.
    • Laparoscopy remains essential for diagnosing small implants and adhesions and for accurate staging.
    • Treatment options include both medical and surgical interventions.