Section I: Definition of deep endometriosis location and its compartments
1. Introduction
2. Definition of deep endometriosis location
2.1. Pelvic location
2.2. Abdominal location
Section II: MRI
3. Technical aspects
3.1. Equipment
3.2. Coil, sequence and image acquisition plan
3.3. Patient preparation
4. Aspects of deep endometriosis on MRI
4.1. Morphology
4.2. Signal intensity
4.3. Enhancement pattern
4.4. Pelvic and abdominal adherences
Section III: Deep endometriosis by location
5. Pelvic location
5.1. Anterior compartment
5.1.1. Urinary tract (urinary bladder and terminal ureter)
5.1.2. Urinary bladder
5.1.3. Ureter
5.1.4. Round ligament
5.1.5. Myometrium
5.2. Posterior compa
rtment
5.2.1. Retrocervical region
5.2.2. Rectovaginal septum
5.2.3. Uterosacral ligaments
5.2.4. Vagina – Posterior vaginal fornix
5.2.5. Myometrium
5.2.6. Rectosigmoid colon
5.3. Lateral compartment
5.3.1. Parametrium and paracolpos
5.3.2. Parametrium and paracolpos/ureter
5.3.3. Hypogastric nerve
5.3.4. Pelvic floor
5.3.5. Ovarian fossa
6. Abdominal location
6.1. Abdominal wall
6.1.1. C-section scar, navel
6.1.2. Inguinal region or canal of Nuck
6.2. Appendix, cecum, and terminal ileum
6.3. Diaphragm
Section IV: Use of MRI on risk stratification and patient follow up
7. Risk stratification
8. Patient follow up
Section V: Postsurgical findings on deep endometriosis
9. Postsurgical findings
9.1. Fibro-cicatricial tissue
9.2. Non-signal foci on surgical bed
9.3. Vaginal fornix and cervix resection
9.4. Parametrium alterations
9.5. Colorectal anastomosis
10. Complications
10.1. Defecation disorders
10.2. Vesicle dysfunction
10.3. Rectovaginal fistula
11. Residual lesion/recurrence
11.1. Ovary
11.2. Infiltrative endometriosis
Alice Brandão
Radiologist, specialized in gynecological imaging, currently serving at Clinica Felippe Mattoso, Rio de Janeiro, Brazil. Fellowship in MRI at Karolinska Hospital, Sweden, and Massachusetts General Hospital, USA. Author of the books “Gynecology and obstetric MRI” (2002, in Portuguese), “Breast MRI” (2010, in Portuguese and Spanish) and “Atlas of deep endometriosis: MRI with laparoscopy correlation” (2014, in Portuguese and Spanish).
Claudio Peixoto Crispi
Gynecologist, specialized in videolaparoscopy, hysteroscopy. Professor and coordinator of the Endoscopic Gynecology post-graduate program at SUPREMA, Brazil. Former president of the Brazilian Society of Minimally Invasive and Robotic Surgery.
Marco Aurelio Pinho de Oliveira
Professor and chief of the department of gynecology at Rio de Janeiro State University, Brazil. Chief of the Endometriosis clinic at Pedro Ernesto Hospital, Rio de Janeiro, Brazil. Former member of AAGL Board of Trustees (2011-2013).
This Atlas presents an MRI-based guide to the diagnosis, treatment and follow up of deep endometriosis. Developed by professionals with a extensive clinical experience in the diagnosis and treatment of deep endometriosis, it provides a global overview of the disease, from basic clinical aspects of imaging diagnosis, to the correlation with surgical findings and histopathological results.
Deep endometriosis is a serious gynecological condition, which can severely impact on women’s quality of life. It shares the main features of regular endometriosis, but also displays a highly infiltrative pattern, involving multiple organs and leading to severe symptoms such as dysmenorrhea, chronic pelvic pain and dyspareunia.
Atlas of Deep Endometriosis – MRI and Laparoscopic Correlations is a complete guide, intended for radiologists, gynecologists and all other medical professionals interested on the diagnosis and treatment of deep endometriosis.
(NOTE: This title was previously published in 2014 in Portuguese and Spanish and comes from our partnership with Brazilian publisher, Revinter.)