Department of Radiology, School of Medicine, National and Kapodistrian University of Athens, Aretaieion hospital, 76, Vassilisis-Sofias Ave., 11528 Athens, Greece.
Department of Gynaecology and Obstetrics, Rea maternity hospital, 383, Sygrou Ave., 17564 Athens, Greece.
Diagn Interv Imaging. 2017 Nov;98(11):751-767. doi: 10.1016/j.diii.2017.05.009. Epub 2017 Jun 23.
Endometriosis is a common gynecological disorder defined by the presence of endometrial tissue outside the uterus. It is the most common cause of chronic pelvic pain and typically affects the ovaries, uterine ligaments, peritoneum, tubes, rectovaginal septum and bladder. It may, however, be found at various extrapelvic sites, including the perineum, liver, pancreas, lung or even the central nervous system, and in such cases, diagnosis may be quite challenging. Even though definitive diagnosis requires laparoscopy, preoperative identification of endometriosis is important not only to differentiate it from other diseases with similar clinical presentations but also, for accurate presurgical mapping, since complete removal of all endometriotic foci is critical for the effective treatment of the patient's symptoms. Ultrasound is performed initially, but magnetic resonance imaging (MRI) is increasingly being used, particularly when sonographic findings are unclear, when deep pelvic endometriosis is suspected or when surgery is planned, as it provides better contrast resolution and a larger field of view compared to ultrasound. In this article, we will discuss distinctive MRI appearances of endometriotic foci and we will review common and uncommon locations of endometriosis within the body, in an attempt to familiarize radiologists with its wide spectrum of manifestations.
子宫内膜异位症是一种常见的妇科疾病，其定义为子宫内膜组织出现在子宫以外的部位。它是慢性盆腔疼痛的最常见原因，通常影响卵巢、子宫韧带、腹膜、输卵管、直肠阴道隔和膀胱。然而，它也可能出现在各种盆腔外部位，包括会阴、肝脏、胰腺、肺，甚至中枢神经系统，在这种情况下，诊断可能具有挑战性。尽管明确诊断需要腹腔镜检查，但术前识别子宫内膜异位症非常重要，不仅要将其与具有相似临床表现的其他疾病区分开来，还要进行准确的术前定位，因为彻底切除所有子宫内膜异位病灶对于有效治疗患者的症状至关重要。最初进行超声检查，但越来越多地使用磁共振成像（MRI），特别是在超声检查结果不明确、怀疑深部盆腔子宫内膜异位症或计划手术时，因为与超声相比，MRI 提供更好的对比度分辨率和更大的视野。在本文中，我们将讨论子宫内膜异位病灶的独特 MRI 表现，并复习身体内常见和不常见的子宫内膜异位症部位，旨在使放射科医生熟悉其广泛的表现谱。
