Endometriosis MRI

Endometriosis MRI Findings – Comprehensive Guide

Endometriosis and MRI

Magnetic Resonance Imaging (MRI) is one of the most important imaging methods, especially in the evaluation of deep infiltrative endometriosis. It provides high accuracy in cases where ultrasound is limited.

Endometrioma (Ovarian Endometriosis)

The most typical finding on MRI is hyperintensity on T1-weighted images and signal loss, known as the 'shading sign', on T2-weighted images. This finding reflects chronic blood content.

Deep Infiltrative Endometriosis (DIE)

DIE lesions are typically seen as hypointense, irregularly bordered nodules on T2-weighted images. They may show invasion into surrounding tissues.

Uterosacral Ligament Involvement

Seen as thickened, hypointense bands. It can often be bilateral and is associated with pelvic pain.

Rectovaginal Septum and Vaginal Involvement

Nodular, fibrotic, and hypointense lesions are observed in these areas. This may indicate advanced-stage disease.

Bowel Involvement

Wall thickening, luminal narrowing, and hypointense nodules are observed in the rectosigmoid region. It shows characteristic low signal on T2.

Bladder and Ureter Involvement

Thickening of the bladder wall and nodular lesions may be seen. Ureter involvement can result in hydronephrosis.

Association with Adenomyosis

On MRI, junctional zone thickening (>12 mm), heterogeneous myometrium, and small cystic areas suggest adenomyosis.

Contrast-Enhanced MRI Findings

Lesions typically show mild-to-moderate contrast enhancement. Fibrotic areas enhance less.

Advantages of MRI

Its most important advantages include comprehensive area assessment, visualization of deep lesions, and contribution to surgical planning.

Conclusion

MRI is an indispensable tool for diagnosis and surgical planning, especially in complex and deep endometriosis cases. It provides high accuracy with experienced evaluation.