Endometriosis: Radiologic-pathologic correlation

Endometriosis is an important gynecologic disorder primarily affecting wome n during their reproductive years. Pathologically, it is the result of func tional endometrium located outside the uterus. It may vary from microscopic endometriotic implants to large cysts (endometriomas). The physical manife stations are protean, with some patients being asymptomatic and others havi ng disabling pelvic pain, infertility, or adnexal masses. Symptoms do not n ecessarily correlate with the severity of the disease. Ultrasonographic (US ) features are variable and can mimic those of other benign and malignant o varian lesions. Low-level internal echoes and echogenic wall foci are more specific US features for endometriomas. Magnetic resonance imaging improves diagnostic accuracy, with endometriotic cysts typically appearing with hig h signal intensity on TI-weighted images and demonstrating "shading" on T2- weighted images. The ovaries are the most common sites affected, but endome triosis can also involve the gastrointestinal tract, urinary tract, chest, and soft tissues. Small implants and adhesions are not well evaluated radio logically; therefore, laparoscopy remains the standard of reference for dia gnosis and staging. Both medical and surgical treatment options are availab le depending on the patients specific case.