Role of Ultrasound and MRI In diagnosis of pelvic endometriosis and adenomyosis

Dr.Mahmoud Elhamedi

doi:10.54361/

Authors

Dr.Mahmoud Elhamedi Gynacology faculty of medicine, Zawia University, Libya Author

DOI:

https://doi.org/10.54361/

Keywords:

Ectopic Endometrium, Ultrasound, MRI and Intervention plan.

Abstract

Background: Endometriosis is a condition where tissue similar to the lining of the uterus; the endometrial stroma and glands,endometriosis was further classified as endometriosis interna and endometriosis externa.Some patients with endometriosis being asymptomatic and others have disabling pelvic pain, infertility, or adnexal masses. Methods: Conducted on 20 Patients diagnosed clinically as endometriosis and/or adenomyosis and fulfilling the inclusion and exclusion criteria aiming to prove the ability of ultrasound and MRI to accurately diagnose ectopic endometrial lesions like endometriosis and adenomyosis. Results: MRI proved the true positive presence of endometriosis and/or adenomyosis in 15 out of 20 cases (75%). Pure endometriosis was actually diagnosed in 10 cases from all 15 true positive cases (66.6%), adenomyosis was diagnosed in 3 cases (20%), and mixed endometriosis and adenomyosis were diagnosed in 2 cases (13.4%). Associated MRI findings included uterine fibroids (26.6%), adhesions in (40%), and Hematosalpinx (20%) from all 15 true positive cases .

References

Chamié LP, Blasbalg R, Pereira RMA, et al. Findings of Pelvic Endometriosis at Transvaginal US, MR Imaging, and Laparoscopy. RadioGraphics 2011; 31:E77-E100.

Tamai K, Koyama T, Umeoka S, et al. Spectrum of MR features in adenomyosis. Best Pract Res Clin Obstet Gynaecol. 2006; 20(4):583-602

Tamai K, Togashi K, Ito T et al. MR Imaging Findings of Adenomyosis: Correlation with Histopathologic Features and Diagnostic Pitfalls. RadioGraphics 2005; 25:21–40

Choudhary S, Fasih N, Papadatos D et al. Unusual Imaging Appearances of Endometriosis. AJR 2009; 192:1632–1644.

Woodward PJ, Sohaey R, Mezzetti TP et al. Endometriosis: Radiologic-Pathologic Correlation. Radio Graphics 2001; 21:193–216.

Ewa Kuligowska, Linda Deeds, Kang Lu. Pelvic Pain: Overlooked and Underdiagnosed Gynecologic Conditions1 RadioGraphics 2005; 25:3–20

Bazot M, Bornier C, Dubernard G, et al. Accuracy of magnetic resonance imaging and rectal endoscopic sonography for the prediction of location of deep pelvic endometriosis. Hum Reprod 2007; 22:1457–1463.

Bazot M, Gasner A, Lafont C et al. Deep pelvic endometriosis: Limited additional diagnostic value of post contrast in comparison with conventional MR images. European Journal of Radiology 2011;80 : 331–339.

Takeuchi H, Kitade M, Kikuchi I, Kumakiri J, Kuroda K, Jinushi M. Diagnosis, laparoscopic management, and histopathologic findings of juvenile cystic adenomyoma: a review of nine cases. Fertil Steril 2010;94:862–8.

Takeuchi M and Matsuzaki K. Adenomyosis: Usual and Unusual Imaging Manifestations, Pitfalls, and Problem-solving MR Imaging Techniques. RadioGraphics 2011; 31:99–115.

Takeuchi M, Matsuzaki K, Nishitani H. Hyperintense uterine myometrial masses on T2-weighted magnetic resonance imaging: differentiation with diffusion-weighted magnetic resonance imaging. J Comput Assist Tomogr 2009;33(6):834–837.

Champaneria R, Abedin P, Daniels J et al. Ultrasound scan and magnetic resonance imaging for the diagnosis of adenomyosis: systematic review comparing test accuracy. Acta Obstetricia et Gynecologica 2010; 89: 1374–1384.

Stamatopoulos CP, Mikos T, Grimbizis GF et al., Value of magnetic resonance imaging in diagnosis of adenomyosis and myomas of the uterus. J Minim Invasive Gynecol 2012 Sep; 19(5):620-626.