|ECR 2018 / C-3194|
|Deep endometriosis of the posterior pelvic compartment:a MRI pictorial guide.|
Endometriosis is a chronic inflammatory disease affecting mainly women during the reproductive age and it is characterized by the presence of endometrial tissue outside the endometrium .
Endometriosis is a multi-factorial disorders with an unclear etiology and pathogenesis. Three are the main theories proposed.
The metastatic theory, which is the most widely accepted, assumes that endometrial cells are transported by retrograde menstrual flux on the surface of the peritoneal cavity. Vascular-lymphatic pathways and intraoperative implants were also proposed as routes of metastatic spread [1-2].
The metaplastic theory suggests the differentiation of peritoneal cells into functioning endometrial cells due to the common embryological origin of peritoneal and endometrial cells from the coelomic epitelium. Differentiation from müllerian remnant tissue was also suggested [1-2].
The induction theory assumes that substances realeased by shed endometrium induce the transformation of undifferentiated parenchyma into endometrial tissue [1-2].
A correct diagnosis and localization of the disease as accurate as possible is mandatory for the preoperative planning. Laparoscopy is the gold standard technique for the diagnosis and treatment.
MRI represents the best non-invasive imaging method for the diagnosis of endometriosis due to its intrinsic high spatial resolution and tissue characterization, allowing a complete survey of the pelvis without the use of ionizing radiations .