Endometriosis MRI: Atypical cases, pitfalls and mimics.

Area of Science:

• Gynecological Imaging
• Diagnostic Radiology
• Pelvic Diseases

Background:

• Endometriosis is a prevalent chronic gynecological condition.
• It is frequently underdiagnosed due to its ability to mimic other diseases clinically and radiographically.
• Endometriosis has diverse classifications, including superficial pelvic endometriosis, deep invasive endometriosis (DIE), and endometrioma, which can resemble neoplastic conditions.

Purpose of the Study:

• To review the imaging characteristics of endometriosis on MRI.
• To highlight common mimics and diagnostic pitfalls in the interpretation of endometriosis.
• To discuss atypical presentations of endometriosis, particularly on MRI.

Main Methods:

• Review of relevant literature on endometriosis imaging.
• Analysis of MRI findings in various endometriosis presentations.
• Comparison of MRI with ultrasound for endometriosis detection.

Main Results:

• MRI offers a larger field of view than ultrasound for detecting endometriosis nodules.
• MRI aids in differentiating endometriosis from malignancy with higher confidence.
• Deep invasive endometriosis (DIE) and endometriomas can mimic invasive neoplasms on imaging.

Conclusions:

• MRI is a valuable tool for diagnosing endometriosis, especially in complex or atypical cases.
• Awareness of endometriosis mimics and pitfalls on MRI is crucial for accurate diagnosis.
• This review provides insights into recognizing endometriosis and its differential diagnoses on MRI.