ARRS 2022 Abstracts


E1840. Multimodality Imaging of Endometriosis: A Primer for Radiologists
  1. Jaspreet Hira; University of North Carolina
  2. Kristen Olinger; University of North Carolina
  3. Josephine Finazzo; University of North Carolina
  4. Ersan Altun; University of North Carolina
Endometriosis is defined as ectopic endometrial tissue outside of the endometrial cavity. Further classification includes the three categories of ovarian endometriomas, superficial peritoneal endometriosis, and deep infiltrative endometriosis. There is an estimated 10% prevalence among reproductive-aged women, and symptomatic females may present with chronic pelvic pain, dyspareunia, or infertility. Laparoscopy remains the gold standard for diagnosis; however, given the morbidity of endometriosis, the radiologist’s role in timely identification and pre-surgical planning through non-invasive imaging is increasing. Thus, a systematic approach to endometriosis imaging is imperative.

Educational Goals / Teaching Points
This exhibit aims to understand the multimodality approach to diagnosing endometriosis along with its typical imaging findings; highlight the pertinent normal anatomical compartments of the female pelvis as seen on ultrasound, CT, and MRI; and accurately utilize the Society of Abdominal Radiology Disease-Focused Panel (SAR-DFP) endometriosis lexicon in reports.

Key Anatomic/Physiologic Issues and Imaging Findings/Techniques
In this exhibit, we review the normal anatomy of the female pelvis, including all three pelvic compartments utilizing graphic illustration and annotated radiologic images; introduce a three-step systematic scanning approach for high-yield ultrasound evaluation of endometriosis; demonstrate the typical imaging findings of endometriosis employing ultrasound, CT, and MRI case examples; and provide a comprehensive review of the SAR-DFP lexicon of endometriosis diagnosis and staging through selected cases with an emphasis on MRI.

Endometriosis often provides a diagnostic challenge for both clinicians and radiologists with estimates of average delay in diagnosis ranging from four to six years. As multimodality imaging advances, radiologists must be equipped with the proper knowledge to provide high quality, standardized interpretations of endometriosis imaging findings to help reduce patient morbidity and improve multidisciplinary communication.