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Vol. 59. Issue 4.
Pages 286-296 (July - August 2017)
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Vol. 59. Issue 4.
Pages 286-296 (July - August 2017)
Update in Radiology
DOI: 10.1016/j.rxeng.2017.06.002
Magnetic resonance imaging of pelvic endometriosis
Resonancia magnética de la endometriosis pelviana
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R. Méndez Fernández
Corresponding author
ramiro.mendez@salud.madrid.org

Corresponding author.
, J. Barrera Ortega
Servicio de Radiodiagnóstico, Hospital Clínico San Carlos y RM N.a Sra. del Rosario, Madrid, Spain
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Abstract

Endometriosis is common in women of reproductive age; it can cause pelvic pain and infertility. It is important to diagnose endometriosis and to thoroughly evaluate its extension, especially when surgical treatment is being considered. Magnetic resonance imaging (MRI) with careful examination technique and interpretation enables more accurate and complete diagnosis and staging than ultrasonography, especially in cases of deep pelvic endometriosis. Furthermore, MRI can identify implants in sites that can be difficult to access in endoscopic or laparoscopic explorations.

In this article, we describe the appropriate MRI protocol for the study of pelvic endometriosis and the MRI signs of pelvic organ involvement. It is necessary to know the subtle findings and to look for them so we can ensure that they are not overlooked. We describe clinical grading systems for endometriosis and review the diagnostic efficacy of MRI in comparison with other imaging techniques and surgery.

Keywords:
Endometriosis
Magnetic resonance imaging
MRI
Pelvic pain
Resumen

La endometriosis es una afección frecuente en mujeres en edad reproductiva, que puede causar dolor pelviano e infertilidad. Es importante el diagnóstico correcto y evaluar de forma completa su extensión, especialmente cuando se plantea un tratamiento quirúrgico. La resonancia magnética (RM), con técnica de exploración e interpretación radiológica cuidadas, permite un diagnóstico y estadificación más precisos y completos que la ecografía, especialmente en la endometriosis pelviana profunda. Además, en RM se pueden identificar implantes en localizaciones de difícil acceso para exploraciones endoscópicas o laparoscópicas.

En este artículo describimos el protocolo de RM adecuado para estudiar la endometriosis pelviana, detallando la semiología en RM de la afectación en los órganos de la pelvis. Es necesario conocer y buscar hallazgos sutiles para evitar que pasen desapercibidos. Se describen sistemas de gradación clínica de la endometriosis y se revisa la eficacia diagnóstica de la RM comparada con otras técnicas de imagen y con la cirugía.

Palabras clave:
Endometriosis
Resonancia magnética
Imagen por RM
Dolor pelviano

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