Appearance of abdominal wall endometriosis on MR imaging
Milou P H Busard1, Velja Mijatovic, Cees van Kuijk
1Department of Radiology, Endometriosis Center VUMC, VU Medical Center, De Boelelaan 1117, 1081 HV, Amsterdam, The Netherlands. m.busard@vumc.nl
Objective:
Abdominal wall endometriosis (AWE) is defined as endometrial tissue that is superficial to the peritoneum. AWE is often difficult to diagnose, mimicking a broad spectrum of diseases. The aim of this study was to describe the appearance of AWE on magnetic resonance (MR) imaging.
Methods:
We present ten patients with AWE (12 lesions) in which MR imaging was used for diagnosis. MR imaging included T2-weighted imaging and T1-weighted imaging with fat suppression. To assess the value of diffusion-weighted imaging (DWI) in endometriosis, four patients underwent additional DWI. The apparent diffusion coefficient (ADC) was calculated using b values of 50, 400, 800 and 1,200 s/mm(2).
Results:
In most cases, the lesion was located ventral or dorsal to the aponeurosis of the rectus oblique muscle (n = 6) or in the rectus abdominis (n = 5). MR of AWE lesions showed isointense or slightly hyperintense signal compared with muscle on T2-weighted images and showed isointense or slightly hyperintense signal compared with muscle on T1-weighted images with foci of high signal intensity, indicative of haemorrhage. The mean ADC value of AWE was 0.93 x 10(-3)/mm(2)/s.
Conclusion:
MR imaging seems to be useful in determining the location and depth of infiltration in surrounding tissue preoperatively.
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