Endometriosis –Spectrum of MRI Appearances

Endometriosis –Spectrum of MRI Appearances

Thomas Jefferson UniversityPhiladelphia, PA

Donald G. Mitchell, M.D.

•Differential Diagnosis

•Invasive Endometriosis

MRI Features of Endometriosis

• Hyperconcentrated Blood» Intense T1 signal» Decreased T2 signal (“shading”)

• Irregular edges

• Multiplicity

• Scarring, proliferative response

Dermoid,

Endometriosis

Dermoid,

Endometriosis

EndometriosisEndometriosis

T1 FatSat

T2-FSE

T1-SE

T2W

T1-FS

Adenomyosis

Sag T2 Sag T2

Invasive Endometriosis

7-year intervalEndometriosis

42 y.o. with Hematuria

Sag T2

* *

* = Uterus

Carolyn Reinhold, MD; McGill

42 y.o. with hematuria

Ax T2

Ax T1 FS Ax T1 C Ax T1 C

Scar Endometriosis

SagSag

AxialAxial

SagSag

AxialAxial

CoronalCoronal

1.Endometriosis is common, and best evaluated by MRI.

2.Endometriomas are not cysts; they are collections of hyperconcentrated blood.

3.Invasive endometriosis results when endometrial implants incite a proliferative response, similar to adenomyosis.