Findings of Pelvic Endometriosis at Transvaginal US, MR Imaging, and Laparoscopy
Abstract
Endometriosis is a common multifocal gynecologic disease that manifests during the reproductive years, often causing chronic pelvic pain and infertility. It may occur as invasive peritoneal fibrotic nodules and adhesions or as ovarian cysts with hemorrhagic content. Although findings at physical examination may be suggestive, imaging is necessary for definitive diagnosis, patient counseling, and treatment planning. The imaging techniques that are most useful for preoperative disease mapping are transvaginal ultrasonography (US) after bowel preparation, and magnetic resonance (MR) imaging. Initial transvaginal US is a reliable technique for detecting rectosigmoid endometriotic lesions. MR imaging is indicated as a complementary examination in complex cases of endometriosis with extensive adhesions and ureteral involvement. Peritoneal endometriotic implants are typically hypoechoic on transvaginal US images and demonstrate low signal intensity on T2-weighted MR images. Endometriotic implants most commonly are found in retrocervical and rectosigmoid sites, followed by the vagina, bladder, and ureters. Cysts with low-level internal echoes and echogenic peripheral foci at transvaginal US are suggestive of endometriomas. MR imaging has high specificity for identifying endometriomas, which are characterized by high signal intensity on T1-weighted images and low signal intensity on T2-weighted images. Correlation of the radiologic imaging features of endometriotic lesions with their laparoscopic appearances may help improve individual proficiency in the radiologic diagnosis of endometriosis.
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Different techniques for diagnostic and preoperative imaging of endometriosis are being explored, including ultrasound, computed tomography, and magnetic resonance imaging.
“Different techniques for diagnostic and preoperative imaging of endometriosis are being explored, including ultrasound, computed tomography, and magnetic resonance imaging.21”
From Defining Future Directions for Endometriosis Research: Workshop Report From the 2011 World Congress of Endometriosis in Montpellier, France (2013) · cites this paper as [21]
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- Authors
- Chamié, L. P., Blasbalg, R., Pereira, R. M. A., Warmbrand, G., & Serafini, P. C.
- Affiliations
- Fleury S.A. (Brazil) (BR)
- Universidade de São Paulo (BR)
- ORCID
- Venue
- RadioGraphics
- Published
- 2011-07
- Volume
- 31
- Issue
- 4
- Pages
- E77-E100
- ISSN
- 0271-5333 (ISSN-L)
- 1527-1323
- OpenAlex
- W2109580987
- Cited by
- 219
- References
- 44
- Citations by year
- 2026: 4 · 2025: 12 · 2024: 16 · 2023: 11 · 2022: 12 · 2021: 20 · 2020: 14 · 2019: 23 · 2018: 25 · 2017: 13 · 2016: 9 · 2015: 11 · 2014: 18 · 2013: 18 · 2012: 12
- FWCI
- 17.51
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Radiographics (publishedVersion)
- PubMed (publishedVersion)
- Scientific Electronic Library Online (São Paulo Research Foundation, Latin American and Caribbean Center on Health Sciences Information, Conselho Nacional de Desenvolvimento Científico e Tecnológico) (publishedVersion)
- Topics
- Health Sciences › Medicine › Reproductive Medicine › Endometriosis Research and Treatment
- Health Sciences › Medicine › Obstetrics and Gynecology › Gynecological conditions and treatments
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Ectopic Pregnancy Diagnosis and Management
- Keywords
- pelvic endometriosis, transvaginal ultrasound, magnetic resonance imaging, laparoscopy, endometrioma, rectosigmoid endometriosis, bowel preparation, adhesion, ureteral involvement, radiographic diagnosis, T2-weighted signal intensity
- MeSH terms
- Endometriosis, Female, Humans, Magnetic Resonance Imaging, Pelvis, Laparoscopy, Ultrasonography, Vagina
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