Differential Diagnosis Invasive Endometriosis€¦ · similar to adenomyosis. Qtr . omet on, ev...

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Endometriosis – Spectrum of MRI Appearances Endometriosis – Spectrum of MRI Appearances Thomas Jefferson University Philadelphia, PA Donald G. Mitchell, M.D. Differential Diagnosis Invasive Endometriosis

Transcript of Differential Diagnosis Invasive Endometriosis€¦ · similar to adenomyosis. Qtr . omet on, ev...

Page 1: Differential Diagnosis Invasive Endometriosis€¦ · similar to adenomyosis. Qtr . omet on, ev ,nua ed meti are rcol ce ive e ndo ilar to . Title: Microsoft PowerPoint - Mitchell

Endometriosis –Spectrum of MRI Appearances

Endometriosis –Spectrum of MRI Appearances

Thomas Jefferson UniversityPhiladelphia, PA

Donald G. Mitchell, M.D.

•Differential Diagnosis

•Invasive Endometriosis

Page 2: Differential Diagnosis Invasive Endometriosis€¦ · similar to adenomyosis. Qtr . omet on, ev ,nua ed meti are rcol ce ive e ndo ilar to . Title: Microsoft PowerPoint - Mitchell

MRI Features of Endometriosis

• Hyperconcentrated Blood» Intense T1 signal» Decreased T2 signal (“shading”)

• Irregular edges

• Multiplicity

• Scarring, proliferative response

Page 3: Differential Diagnosis Invasive Endometriosis€¦ · similar to adenomyosis. Qtr . omet on, ev ,nua ed meti are rcol ce ive e ndo ilar to . Title: Microsoft PowerPoint - Mitchell

Dermoid,

Endometriosis

Dermoid,

Endometriosis

Page 4: Differential Diagnosis Invasive Endometriosis€¦ · similar to adenomyosis. Qtr . omet on, ev ,nua ed meti are rcol ce ive e ndo ilar to . Title: Microsoft PowerPoint - Mitchell

EndometriosisEndometriosis

T1 FatSat

T2-FSE

T1-SE

Page 5: Differential Diagnosis Invasive Endometriosis€¦ · similar to adenomyosis. Qtr . omet on, ev ,nua ed meti are rcol ce ive e ndo ilar to . Title: Microsoft PowerPoint - Mitchell

T2W

T1-FS

Page 6: Differential Diagnosis Invasive Endometriosis€¦ · similar to adenomyosis. Qtr . omet on, ev ,nua ed meti are rcol ce ive e ndo ilar to . Title: Microsoft PowerPoint - Mitchell

Adenomyosis

Page 7: Differential Diagnosis Invasive Endometriosis€¦ · similar to adenomyosis. Qtr . omet on, ev ,nua ed meti are rcol ce ive e ndo ilar to . Title: Microsoft PowerPoint - Mitchell

Sag T2 Sag T2

Invasive Endometriosis

Page 8: Differential Diagnosis Invasive Endometriosis€¦ · similar to adenomyosis. Qtr . omet on, ev ,nua ed meti are rcol ce ive e ndo ilar to . Title: Microsoft PowerPoint - Mitchell

7-year intervalEndometriosis

Page 9: Differential Diagnosis Invasive Endometriosis€¦ · similar to adenomyosis. Qtr . omet on, ev ,nua ed meti are rcol ce ive e ndo ilar to . Title: Microsoft PowerPoint - Mitchell

42 y.o. with Hematuria

Sag T2

* *

* = Uterus

Carolyn Reinhold, MD; McGill

Page 10: Differential Diagnosis Invasive Endometriosis€¦ · similar to adenomyosis. Qtr . omet on, ev ,nua ed meti are rcol ce ive e ndo ilar to . Title: Microsoft PowerPoint - Mitchell

42 y.o. with hematuria

Ax T2

Ax T1 FS Ax T1 C Ax T1 C

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Scar Endometriosis

Page 12: Differential Diagnosis Invasive Endometriosis€¦ · similar to adenomyosis. Qtr . omet on, ev ,nua ed meti are rcol ce ive e ndo ilar to . Title: Microsoft PowerPoint - Mitchell

SagSag

AxialAxial

SagSag

AxialAxial

CoronalCoronal

Page 13: Differential Diagnosis Invasive Endometriosis€¦ · similar to adenomyosis. Qtr . omet on, ev ,nua ed meti are rcol ce ive e ndo ilar to . Title: Microsoft PowerPoint - Mitchell
Page 14: Differential Diagnosis Invasive Endometriosis€¦ · similar to adenomyosis. Qtr . omet on, ev ,nua ed meti are rcol ce ive e ndo ilar to . Title: Microsoft PowerPoint - Mitchell

1.Endometriosis is common, and best evaluated by MRI.

2.Endometriomas are not cysts; they are collections of hyperconcentrated blood.

3.Invasive endometriosis results when endometrial implants incite a proliferative response, similar to adenomyosis.