Magnetic resonance imaging and serum CA-125 in evaluating patients with endometriomas prior to medical therapy

Case report: MR imaging features of endometriosis at the umbilicus

The radiological features of extrapelvic endometriosis at the umbilicus with large ovarian endometriomas are described. In this patient, the umbilical lesion appears as hypointense on T(1) weighted and T(2) weighted MR images. The MR characteristics of endometriosis at the umbilicus are compared with those found within the pelvis.

[Renal endometriosis. Case report]

The authors report a case of renal endometriosis. The preoperative diagnosis of this pathology is difficult because the clinical aspect and the radiological appearance are non specific. This fact limits the place of the medical treatment and of the conservative surgery nevertheless desirable in this young population.

Endometriomas: diagnostic performance of US

PURPOSE

To determine the diagnostic performance of specific ultrasonographic (US) features in discriminating endometriomas from other adnexal masses.

MATERIALS AND METHODS

Two sonologists independently reviewed the sonograms of 252 adnexal masses in 226 women and recorded US features by using a standardized checklist. The diagnostic performance of specific US features and overall reviewer impression in discriminating endometriomas from other adnexal masses were evaluated.

RESULTS

There were 40 endometriomas. Diffuse low-level internal echoes were present in 38 (95%) endometriomas and 40 (19%) nonendometriomas (positive likelihood ratio, 5). The positive likelihood ratio for the diagnosis of endometrioma increased to 8 if masses with neoplastic features at gray-scale US were excluded, allowing identification of 30 endometriomas (75%). The presence of multilocularity or hyperechoic wall foci further increased the positive likelihood ratio to 48, allowing the identification of 18 endometriomas (45%).

CONCLUSION

An adnexal mass with diffuse low-level internal echoes and absence of particular neoplastic features is highly likely to be an endometrioma if multilocularity or hyperechoic wall foci are present. A patient with a mass with diffuse low-level internal echoes and other US features may benefit from additional imaging.