Computed tomography of endometriosis

Six examples of pelvic masses due to endometriosis were detected by computed tomography (CT) in a group of women aged 30-43. Lower abdominal or pelvic pain was the chief complaint in four cases. The ileum and rectosigmoid were routinely opacified with contrast material prior to examination. Endometriosis exhibited a variety of findings including a constricting rectosigmoid mass, a lesion of the pelvic side wall, bowel wall implants, and posthysterectomy pelvic masses. There was no standard CT density; the lesion near the pelvic side wall appeared solid, one cul-de-sac mass appeared solid, and a second had a mixed cystic and solid appearance. Discrete adnexal endometriosis appeared as thick-walled cystic masses (two cases) or as a simple cyst (one case). Bowel wall involvement and the pelvic side wall lesion were not successfully identified by ultrasound. It is concluded that CT can play a role in the diagnosis of endometriosis.