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Reproductive/Endocrine Imaging

E2932. Emerging MRI Techniques for Characterization of Ectopic Endometrial Tissue

Cajigas-Loyola S1,  Ball J2,  Danrad R1,  Smith D.1 1. Louisiana State University, New Orleans, LA; 2. Tulane University, New Orleans, LA

Address correspondence to S. Cajigas-Loyola (scajig@lsuhsc.edu)

Background Information: This exhibit will review MRI findings of ectopic endometrial tissue like endometriosis, endometrioma, and adenomyosis. It will describe the distinguishing features of those conditions in the context of a differential diagnosis. Many of the foundational imaging findings will be considered through a case-based review of a 44-year old woman who presented with a 14-year history of monthly bleeding through her anterior abdominal scar.

Educational Goals/Teaching Points: After the presentation, the audience will be able to recall the anatomic and pathophysiologic presentation of ectopic endometrial tissue and review the classic MRI findings of ectopic endometrial tissue. We will discuss emerging susceptibility-weighted imaging (SWI) techniques and utility to enhance MRI detection of ectopic endometrial tissue.

Key Anatomic/Physiologic Issues and Imaging Findings/Techniques: The exhibit includes female pelvic anatomy review, including typical areas of endometrial implants, and SWI overview and application for visualization of ectopic endometrial tissue.

Conclusion: Endometriosis, endometrioma, and adenomyosis are all manifestations of ectopic endometrial tissue implantation. Their MRI features are reflective of the intrinsic signal characteristics of endometrium and those of the blood products deposited as a result of its presence. New techniques of SWI are a very useful and specific adjunct to well-established MRI methods for locating and evaluating ectopic endometrial tissue within the pelvic cavity.