1
|
Gao M, Bhosale P, Devine C, Palmquist S, Javadi S. US, MRI, CT Performance and Interpretation of Uterine Masses. Semin Ultrasound CT MR 2023; 44:541-559. [PMID: 37821051 DOI: 10.1053/j.sult.2023.10.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/13/2023]
Abstract
Uterine masses are commonly encountered as incidental findings during cross-sectional imaging or when individuals present with symptoms such as pain and bleeding. The World Health Organization categorizes tumors of the uterine corpus into 5 distinct groups: endometrial epithelial tumors and their precursors, tumor-like growths, mesenchymal uterine tumors, tumors with a combination of epithelial and mesenchymal elements, and various other types of tumors. The primary imaging method for assessing uterine abnormalities is transvaginal ultrasound. However, magnetic resonance imaging (MRI) can be employed to enhance the visualization of soft tissues, enabling a more detailed characterization of uterine masses. This article aims to outline the imaging features of both benign and malignant uterine masses using ultrasound, MRI, and computed tomography.
Collapse
Affiliation(s)
- Mamie Gao
- University of Texas MD Anderson Cancer Center, Houston, TX.
| | - Priya Bhosale
- University of Texas MD Anderson Cancer Center, Houston, TX
| | | | | | - Sanaz Javadi
- University of Texas MD Anderson Cancer Center, Houston, TX
| |
Collapse
|
2
|
Fadavi P, Garousi M, Soltani S, Montazer F, Abolhasani M, Asgari S, Mirzaee E. The uterine adenosarcoma with postoperative residual in a woman treated by total abdominal hysterectomy/bilateral salpingo-oophorectomy: A case report and review of literature. Cancer Rep (Hoboken) 2023; 6:e1891. [PMID: 37592402 PMCID: PMC10598255 DOI: 10.1002/cnr2.1891] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2023] [Revised: 07/09/2023] [Accepted: 07/22/2023] [Indexed: 08/19/2023] Open
Abstract
BACKGROUND In patients with uterine adenosarcoma, a total abdominal hysterectomy (TAH) with bilateral salpingo-oophorectomy (BSO) is typically recommended as an initial treatment. There is no consensus on adjuvant therapies. CASE We report the case of a patient with uterine adenosarcoma with postoperative residual disease. We performed four courses of adjuvant chemotherapy, including Ifosfamide, Mesna, and Adriamycin, and whole pelvic radiation with a dose of 50.4 Gy/28 Fr. CONCLUSION A combination of chemotherapy and radiotherapy may be a promising treatment option for uterine adenosarcoma with postoperative residual disease.
Collapse
Affiliation(s)
- Pedram Fadavi
- Department of Radiation Oncology, School of MedicineIran University of Medical SciencesTehranIran
| | - Maryam Garousi
- Department of Radiation Oncology, School of MedicineIran University of Medical SciencesTehranIran
| | - Sepideh Soltani
- Department of Radiation Oncology, School of MedicineIran University of Medical SciencesTehranIran
| | - Fatemeh Montazer
- Department of Pathology, School of MedicineIran University of Medical SciencesTehranIran
| | - Maryam Abolhasani
- Oncopathology Research Center, School of MedicineIran University of Medical SciencesTehranIran
| | - Salar Asgari
- Department of Pathology, School of MedicineIran University of Medical SciencesTehranIran
| | - Elahe Mirzaee
- Department of Radiation Oncology, School of MedicineIran University of Medical SciencesTehranIran
| |
Collapse
|
3
|
Uterine Adenosarcoma with Sarcomatous Overgrowth: A Case Report of Aggressive Disease in a 16-Year-Old Girl and a Literature Review. J Pediatr Adolesc Gynecol 2018; 31:426-431. [PMID: 29317258 DOI: 10.1016/j.jpag.2017.12.012] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/08/2017] [Revised: 12/26/2017] [Accepted: 12/31/2017] [Indexed: 11/21/2022]
Abstract
BACKGROUND Uterine adenosarcoma with sarcomatous overgrowth (ASSO) is a rare and aggressive disease. A case of a 16-year-old girl with uterine ASSO is reported herein. The patient received surgical resection and chemotherapy and remained alive without disease 11 months after the surgery. CASE A 16-year-old girl was diagnosed with uterine ASSO, International Federation of Gynecology and Obstetrics (2009) stage I c. She underwent total abdominal hysterectomy, bilateral salpingectomy, and chemotherapy. She remains alive and there was no evidence of tumor recurrence on follow-up physical, laboratory, and ultrasound scan examinations. SUMMARY AND CONCLUSION Surgery is the primary treatment for uterine ASSO, total abdominal or laparoscopic-assisted vaginal hysterectomy with or without bilateral salpingo-oophorectomy are recommended. Early surgical resection might increase survival of uterine adenosarcoma. Long-term follow-up of the patients is recommended because of the high chance of recurrence.
Collapse
|
4
|
Abstract
OBJECTIVE The role of imaging in patients with suspected gynecologic malignancies is to provide an accurate diagnosis to achieve the best and most tailored treatment plan. Uncommon cancers pose a distinct challenge, because current knowledge of these diseases is still limited. Our purpose is to highlight the role of cross-sectional imaging techniques, including ultrasound, CT, MRI, and PET/CT, in the diagnosis and pretreatment stratification of patients with rare gynecologic cancers. CONCLUSION This review shows the relevance of imaging findings for diagnosis, staging, and treatment planning in patients with uncommon uterine, cervical, vaginal, vulvar, and ovarian cancers.
Collapse
|
5
|
Ceylan Y, Doğer E, Çakıroğlu AY, Vural Ç, Yücesoy İ. Mullerian adenosarcoma of the uterus associated with tamoxifen treatment for breast cancer. Turk J Obstet Gynecol 2015; 12:244-247. [PMID: 28913077 PMCID: PMC5588479 DOI: 10.4274/tjod.44341] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2015] [Accepted: 11/26/2015] [Indexed: 12/01/2022] Open
Abstract
Mullerian adenosarcoma following tamoxifen therapy is a rare condition. Our aim was to report the youngest patient in the literature with uterine mullerian adenosarcoma who was undergoing tamoxifen therapy for breast cancer. A premenopausal woman aged 38 years who was undergoing tamoxifen therapy for breast cancer, was admitted with symptoms of lower abdominal pain and irregular vaginal bleeding and malodorous vaginal discharge that had continued for at least 6 months. A pelvic examination revealed a large and malodorous polypoid mass protruding through the cervix and an enlarged uterus. A biopsy from the protruding polypoid mass was reported as a large area of necrosis with neoplastic mesenchymal cells. The patient underwent a total abdominal hysterectomy, bilateral salpingo-oopherectomy, pelvic-paraaortic lymph node dissection, and omentectomie. The histologic diagnosis was Mullerian adenosarcoma. As a result, she was discharged to the oncology department. The woman is alive and her chemoradiotherapy treatment is ongoing. The role of tamoxifen therapy in the development of endometrial neoplasms remains unclear, but all cases of endometrial thickening and vaginal bleeding must be investigated for Mullerian adenosarcoma in tamoxifen users.
Collapse
Affiliation(s)
- Yasin Ceylan
- Kocaeli University Faculty of Medicine, Department of Obstetrics and Gynecology Kocaeli, Turkey
| | - Emek Doğer
- Kocaeli University Faculty of Medicine, Department of Obstetrics and Gynecology Kocaeli, Turkey
| | - Ahmet Yiğit Çakıroğlu
- Kocaeli University Faculty of Medicine, Department of Obstetrics and Gynecology Kocaeli, Turkey
| | - Çiğdem Vural
- Kocaeli University Faculty of Medicine, Department of Pathology, Kocaeli, Turkey
| | - İzzet Yücesoy
- Kocaeli University Faculty of Medicine, Department of Obstetrics and Gynecology Kocaeli, Turkey
| |
Collapse
|
6
|
Zhang GF, Zhang H, Tian XM, Zhang H. Magnetic resonance and diffusion-weighted imaging in categorization of uterine sarcomas: correlation with pathological findings. Clin Imaging 2014; 38:836-44. [PMID: 25027800 DOI: 10.1016/j.clinimag.2014.06.004] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2014] [Revised: 05/19/2014] [Accepted: 06/02/2014] [Indexed: 12/14/2022]
Abstract
OBJECTIVES We investigated the utility of magnetic resonance imaging (MRI) and diffusion-weighted imaging (DWI) in the categorization of uterine sarcoma (US) and compared them with pathological findings. METHODS The baseline and MRI characteristics were recorded and compared across the subtypes of USs. RESULTS There were no differences in the conventional or DWI signals among the four subtypes of US, except in the heterogeneity of T2-weighted imaging. A difference in the mean apparent diffusion coefficient value for USs and uterine fibroids differed significantly (P=.019). CONCLUSIONS MRI characteristics showed no specific differences between any subtypes of US.
Collapse
Affiliation(s)
- Guo-Fu Zhang
- Department of Radiology, Obstetrics and Gynecology Hospital, Fudan University
| | - He Zhang
- Department of Radiology, Obstetrics and Gynecology Hospital, Fudan University.
| | - Xiao-Mei Tian
- Department of Radiology, Obstetrics and Gynecology Hospital, Fudan University
| | - Hao Zhang
- Department of Pathology, Obstetrics and Gynecology Hospital, Fudan University
| |
Collapse
|
7
|
Tirumani SH, Ojili V, Shanbhogue AKP, Fasih N, Ryan JG, Reinhold C. Current concepts in the imaging of uterine sarcoma. ACTA ACUST UNITED AC 2013; 38:397-411. [PMID: 22699695 DOI: 10.1007/s00261-012-9919-x] [Citation(s) in RCA: 50] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Abstract
Recent advances in genetics and pathology have improved our understanding of diagnosis and staging of uterine sarcomas. The major types of uterine sarcomas include leiomyosarcoma, low-grade endometrial stromal sarcoma, undifferentiated endometrial sarcoma, adenosarcoma and carcinosarcoma. The distinctive biological behavior and poor overall survival of uterine sarcoma create challenges in the management of these tumors. We herein present a comprehensive review of taxonomy, epidemiology, pathology, imaging findings and natural history of a wide spectrum of uterine sarcomas.
Collapse
Affiliation(s)
- Sree Harsha Tirumani
- Department of Diagnostic Radiology, Montreal General Hospital, McGill University Health Centre, 1650 Ave Cedar, Montreal, QC, H3G 1A4, Canada
| | | | | | | | | | | |
Collapse
|
8
|
Kobayashi H, Uekuri C, Akasaka J, Ito F, Shigemitsu A, Koike N, Shigetomi H. The biology of uterine sarcomas: A review and update. Mol Clin Oncol 2013; 1:599-609. [PMID: 24649216 PMCID: PMC3916197 DOI: 10.3892/mco.2013.124] [Citation(s) in RCA: 40] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2012] [Accepted: 04/08/2013] [Indexed: 12/31/2022] Open
Abstract
Uterine sarcoma is a rare neoplasm, accounting for only 5% of uterine malignancies. The pathogenesis of uterine sarcoma remains largely unknown, although recent basic science and pre-clinical animal models have provided a better understanding of tumor biology. The aim of this study was to review the clinical features, imaging characteristics, genetic aberrations and therapeutic approaches in uterine sarcoma. This study reviewed the English-language literature on clinical and basic studies on uterine sarcoma. The common variants of uterine sarcoma are carcinosarcoma, leiomyosarcoma and endometrial stromal sarcoma (ESS). Genetic profiling efforts have identified amplification, overexpression and mutation, while the molecular mechanisms of tumorigenesis driven by these genomic and genetic aberrations have yet to be fully elucidated yet. Recent genome-wide studies have also identified complex chromosomal rearrangements as oncogenic mechanisms. The cell cycle regulators, p16 and p53, are frequently over-expressed and appear to be involved in key modifications of sarcomagenesis. Molecular-targeted therapy has now been evaluated in clinical trials for certain subtypes. In conclusion, aberrations of cell cycle control would be a critical step in the development of uterine sarcoma. This review has provided new areas of study targeting molecular and genetic pathways.
Collapse
Affiliation(s)
- Hiroshi Kobayashi
- Department of Obstetrics and Gynecology, Nara Medical University, Nara 634-8522, Japan
| | - Chiaki Uekuri
- Department of Obstetrics and Gynecology, Nara Medical University, Nara 634-8522, Japan
| | - Juria Akasaka
- Department of Obstetrics and Gynecology, Nara Medical University, Nara 634-8522, Japan
| | - Fuminori Ito
- Department of Obstetrics and Gynecology, Nara Medical University, Nara 634-8522, Japan
| | - Aiko Shigemitsu
- Department of Obstetrics and Gynecology, Nara Medical University, Nara 634-8522, Japan
| | - Natsuki Koike
- Department of Obstetrics and Gynecology, Nara Medical University, Nara 634-8522, Japan
| | - Hiroshi Shigetomi
- Department of Obstetrics and Gynecology, Nara Medical University, Nara 634-8522, Japan
| |
Collapse
|
9
|
Yoshizako T, Wada A, Kitagaki H, Ishikawa N, Miyazaki K. MR imaging of uterine adenosarcoma: case report and literature review. Magn Reson Med Sci 2012; 10:251-4. [PMID: 22214910 DOI: 10.2463/mrms.10.251] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
We report a case of uterine adenosarcoma demonstrated on magnetic resonance (MR) imaging. A 74-year-old woman with a large uterine mass underwent MR examination before total abdominal hysterectomy. Imaging revealed a markedly enlarged uterus with thin myometrium occupied by a large polypoid mass. The mass contained solid components with low intensity on T(1)-weighted images and high intensity on T(2)-weighted images compared to the myometrium and areas of small cysts.
Collapse
Affiliation(s)
- Takeshi Yoshizako
- Department of Radiology, Shimane University Faculty of Medicine, Izumo, Japan.
| | | | | | | | | |
Collapse
|
10
|
Lee EJ, Joo HJ, Ryu HS. Malignant mixed Müllerian tumors of the uterus: sonographic spectrum. ULTRASOUND IN OBSTETRICS & GYNECOLOGY : THE OFFICIAL JOURNAL OF THE INTERNATIONAL SOCIETY OF ULTRASOUND IN OBSTETRICS AND GYNECOLOGY 2012; 39:348-353. [PMID: 21919101 DOI: 10.1002/uog.10085] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
OBJECTIVE To describe the sonographic findings for malignant mixed Müllerian tumors (MMMTs) of the uterus with particular emphasis on their features on saline contrast sonohysterography (SCSH) and color Doppler sonography, and to determine how they relate to pathological findings. METHODS The SCSH and color Doppler findings in 29 histologically proven cases of uterine MMMT were reviewed retrospectively and their relationship to gross and histological findings were investigated. RESULTS Of the 29 uterine tumors, 16 were located only in the corpus, nine only in the fundus and four in both the corpus and fundus. Mean tumor size was 5.4 cm. The most common appearance was a polypoid mass projecting into the endometrial cavity, found in 23 cases. Twenty-eight tumors had an irregular surface, which was papillary in 20 cases and lobulated in eight. Most appeared heterogeneously isoechoic (n = 16) or hypoechoic (n = 12), occasionally with a trabecular appearance, and they often had clefts or fissure-like cystic areas (n = 10), necrosis (n = 4) or hemorrhagic areas (n = 7). Myometrial invasion was present in 27 cases and dilatation of the endometrial cavity was seen in 11. Color Doppler sonography showed moderate to marked vascularity in 20 out of the 24 cases in which it was performed, with a mean resistance index of 0.41, and appeared as feeding (n = 15) or randomly dispersed (n = 9) vessels. CONCLUSIONS Uterine MMMTs have distinct sonographic features that are related to pathological findings. Knowledge of the sonographic appearance of MMMTs may facilitate diagnosis.
Collapse
Affiliation(s)
- E J Lee
- Department of Radiology, Ajou University School of Medicine, Suwon, South Korea.
| | | | | |
Collapse
|
11
|
Chung YW, Bae HS, Han SI, Song JY, Kim IS, Kang JS. Endometrial mullerian adenosarcoma after toremifene treatment in breast cancer patients: a case report. J Gynecol Oncol 2010; 21:269-72. [PMID: 21278890 DOI: 10.3802/jgo.2010.21.4.269] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2010] [Revised: 02/15/2010] [Accepted: 02/19/2010] [Indexed: 11/30/2022] Open
Abstract
Toremifene is an anti-estrogen which has been shown to be effective in the treatment of breast cancer, and is thought to be a less uterotrophic agent than tamoxifen. The risk assessment concerning endometrial cancer has been inconclusive because of its rare use up to the mid-1990s. We report a case of an adenosarcoma, which is a very rare type of uterine malignancy, after toremifene treatment for 5 years in a breast cancer patient. After 1 year of toremifene use, the patient had a benign Mullerian adenofibroma. After an additional 4 years of toremifene treatment, the endometrial polypoid lesion was transformed into a Mullerian adenosarcoma. Although toremifene is a promising anti-estrogenic agent in the treatment of breast cancer patients, clinicians should not neglect the possibility of a uterine malignancy.
Collapse
Affiliation(s)
- Ye Won Chung
- Department of Obstetrics and Gynecology, Korea University College of Medicine, Seoul, Korea
| | | | | | | | | | | |
Collapse
|
12
|
Berman G, Manahan KJ, Geisler JP. Immunohistochemical Profile of Tamoxifen-Related Uterine Adenosarcomas. J Gynecol Surg 2010. [DOI: 10.1089/gyn.2009.0026] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
- Greg Berman
- Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, University of Toledo Medical Center, Toledo, OH
| | - Kelly J. Manahan
- Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, University of Toledo Medical Center, Toledo, OH
| | - John P. Geisler
- Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, University of Toledo Medical Center, Toledo, OH
| |
Collapse
|
13
|
Takeuchi M, Matsuzaki K, Yoshida S, Kudo E, Bando Y, Hasebe H, Kamada M, Nishitani H. Adenosarcoma of the uterus: magnetic resonance imaging characteristics. Clin Imaging 2009; 33:244-7. [PMID: 19411035 DOI: 10.1016/j.clinimag.2008.11.003] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2008] [Revised: 11/20/2008] [Accepted: 11/20/2008] [Indexed: 12/28/2022]
Abstract
Adenosarcoma of the uterus is a rare tumor containing benign glandular epithelial and malignant mesenchymal elements. Typical adenosarcoma is a low-grade tumor, presents as a large polypoid mass occupying the endometrial cavity, and may protrude into the vaginal cavity. The presence of small hyperintense cysts scattered within the mass on T(2)-weighted imaging, reflecting glandular epithelial components, and relatively low signal intensity on high b-value diffusion-weighted imaging, reflecting its low-grade nature, may be characteristic findings.
Collapse
Affiliation(s)
- Mayumi Takeuchi
- Department of Radiology, University of Tokushima, Kuramoto-cho, Tokushima, Japan.
| | | | | | | | | | | | | | | |
Collapse
|
14
|
Gong J, Yu X, Xu J, Wang X. CT imaging of a primary malignant mixed mullerian tumor arising from the peritoneum. Clin Imaging 2008; 32:390-2. [PMID: 18760728 DOI: 10.1016/j.clinimag.2007.12.005] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2007] [Accepted: 11/05/2007] [Indexed: 11/18/2022]
Abstract
Primary peritoneal malignant mixed mullerian tumors are very rare. We report the case of a patient presenting with pain in the right upper quadrant of the abdomen and in whom the physical examination demonstrated a peritoneal mass. Computed tomography (CT) confirmed the presence of a mass, with invasion of adjacent organs.
Collapse
Affiliation(s)
- Jingshan Gong
- Department of Radiology, Shenzhen People's Hospital- Second Clinical College, School of Medicine, Jinan University, 1017 Dongmenbeilu, Shenzhen 518020, Guangdong Province, China.
| | | | | | | |
Collapse
|
15
|
Primary malignant mixed mullerian tumor of the uterus: findings on sonography, CT, and gadolinium-enhanced MRI. AJR Am J Roentgenol 2008; 191:278-83. [PMID: 18562759 DOI: 10.2214/ajr.07.3281] [Citation(s) in RCA: 36] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
OBJECTIVE The purpose of our study was to evaluate the sonographic, contrast-enhanced CT, and gadolinium-enhanced MRI findings of primary malignant mixed müllerian tumors (MMMTs) of the uterus. CONCLUSION Uterine MMMT most commonly presents as an intracavitary mass with coexistent dilatation of the endometrial canal. Tumors tend to appear hyperechoic on sonography, heterogeneously hypodense and ill defined on contrast-enhanced CT, and heterogeneously hyperintense on T2-weighted MR images with signal abnormalities indicating subacute hemorrhage on T1-weighted MR images. Myometrial invasion is common and has a predilection for the uterine fundus.
Collapse
|
16
|
Shetty M, Lal N, Vu NH. Müllerian adenosarcoma of the ovary: case report and review of the literature. Ultrasound Q 2007; 23:189-91. [PMID: 17805167 DOI: 10.1097/ruq.0b013e31814b94f7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Müllerian adenosarcoma is a rare neoplasm that can arise in both uterine and extrauterine locations. This report describes the ultrasound and magnetic resonance imaging findings of one case of ovarian adenosarcoma and reviews the literature as to the previously described imaging findings. Adenosarcoma should be considered in patients with a predominantly solid pelvic mass on imaging, particularly in those with a history of endometriosis or findings compatible with endometriosis on ultrasound or magnetic resonance imaging. A very low resistive index on ultrasound may also be suggestive of this diagnosis.
Collapse
Affiliation(s)
- Monisha Shetty
- Division of Abdominal Imaging, Department of Radiology, Beth Israel Deaconess Medical Center, Boston, MA, USA
| | | | | |
Collapse
|