Endometriosis - University of Malta [PDF]

Endometriosis most commonly affects the ovaries and adjacent

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adhesions.2

induces endometrial differentiation of adjacent normal serosa.3

menstruation.

*corresponding author

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Malta Medical Journal Volume 23 Issue 01 2011

women have endometriosis.6 and autoimmune factors.7 8

If endometriotic Figure 1: Image from intravenous urogram

Involvement of the distal ureters may lead to distal ureteric

Clinical evaluation Intermediate length extrinsic stricture to right ureter below the level of the right sacro-iliac joint due to extrinsic endometriotic deposits (short arrows).

Laparoscopic evaluation 12

Endometriosis.11

Radiological evaluation Plain film radiography, intravenous urography and radiographic bowel imaging

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Contrast enhanced Computed Tomography (CECT)

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Figure 2: Axial contrast enhanced CT image

role in endometriosis is the characterisation of adnexal cysts and

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of non endometriomas.16

Thickening of the recto uterine septum (curved arrow) Note relative lack of tissue differentiation on CECT

Figure 3: Transvaginal ultrasound image

Magnetic resonance imaging The rationale behind MRI imaging in endometriosis

Ultrasonography fashion.

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Figure 4: Axial lfov fat suppressed T2 image

Figure 6: Axial lfov T2 weighted image

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Lesion characteristics on MRI imaging Adnexal endometriotic cysts-endometriomas 18

Figure 5: Axial Sfov T1 weighted image

Malta Medical Journal Volume 23 Issue 01 2011

Figure 7: Para coronal lfov T2 weighted image

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Figure 8: Axial lfov fat suppressed T2 image

Figure 10: Axial Sfov T2 weighted image

Nodular focus of active endometriosis anterior to wall with central high signal altered blood degradation products (bilateral thin arrows).

Figure 9: Axial Sfov T1 weighted fat suppressed image

Figure 11: Para coronal lfov T2 weighted image

Bilateral high signal adnexal endometriotic cysts (thick arrows) and haematosalpinges returning high signal on fat suppression (thin arrows).

Spiculate intermediate signal intensity fibrotic endometriotic nodule in left recto uterine septum (thick

ureter (curved arrow)

and complications

Malta Medical Journal Volume 23 Issue 01 2011

Figure 12: Axial lfov T2 weighted image

Figure 14: Axial Sfov T2 weighted image

rectovaginal septum (thick arrows). Figure 15: Para coronal lfov T2 weighted image

Figure 13: Axial Sfov T2 weighted image

the uterus (thin arrows). Figure 16: Sagittal lfov T2 weighted image

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Thickening of recto vaginal septum (thin arrow) and nodular deposit in relation to anterior rectal wall (thick arrow). Subtle diffuse adenomyosis of the uterus (curved arrow). Previously called endometriosis interna, adenomyosis is commonly associated with endometriosis.

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Figure 17: Para coronal lfov T2 weighted image

Figure 19: Para coronal T1 fat saturated image

Figure 18: Para coronal lfov T2 weighted image Figure 20: Axial T1 weighted image

Prominent left pelvic side wall lymph node (thick arrow)-nodal hypertrophy is a common concomitant of extra-adnexal endometriosis.

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Figure 21: Transabdominal ultrasound image

Figure 23: Axial Sfov T2 weighted image

Figure 22: Transabdominal ultrasound image

Figure 24: Sagittal lfov T2 weighted image

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ed.

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669-76.

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Malta Medical Journal Volume 23 Issue 01 2011