E1738. Deep Infiltrating Endometriosis: Anatomy and MRI Findings
Authors
Eelin Tan;
KK Womens' and Childrens' Hospital
Michael Seng;
KK Womens' and Childrens' Hospital
Li Ching Lau;
KK Womens' and Childrens' Hospital
Background
Treatment of DIE involves symptomatic control, hormone-based medical therapy, and/or surgery. For patients opting for surgical treatment, preoperative identification of DIE sites is crucial. Ultrasound is a good screening tool, but MRI remains superior for the comprehensive characterization of lesions.
Educational Goals / Teaching Points
Relevant anatomy, pathophysiology, and MRI features of DIE.
Key Anatomic/Physiologic Issues and Imaging Findings/Techniques
Definition and pathophysiology of endometriosis. Relevant anatomy including the anterior, middle and posterior pelvic compartments and the structures within each compartment, and common sites for DIE. Extrapelvic anatomy for potential extrapelvic sites for ectopic endometrial implants. MR protocol (at our institution). Main MR features of DIE (with imaging examples) including infiltrating endometrial deposits are T1W isointense and T2W hypointense, occasionally with T2W hyperintense foci representing dilated glands, T2W hypointense thickening of fibromuscular structures such as the uterine ligaments (round ligament, broad ligament uterosacral ligaments), associated fibrous adhesions, and ovarian endometriomas.
Conclusion
MRI is an important diagnostic tool in DIE. This review provides a diagnostic aid for radiologists in the diagnosis and relevant negatives of this entity on MRI.
