Table 1. Key MRI Findings of Ovarian Endometriotic Cyst, DIE, or Other Related Diseases.
MR/CT Sign | MRI/CT Findings | References | ||
---|---|---|---|---|
Ovary | Ovarian endometrioma | T1-high signal multiplicity | Multiple high signal cysts on T1WI | [31] |
T2-Shading | Marked T2 shortening or gradations on T2WI | [31,33] | ||
T2 dark spot sign | Discrete well-defined markedly hypointense foci within the cyst on T2WI | [32] | ||
Decidualization | Linear, broad-based nodular, or polypoid structures with high SI similar to placental tissue on T2WI | [43,44] | ||
Polypoid endometriosis | Polypoid mass, slightly high SI similar to endometrium on T2WI | [46,47,48] | ||
Punctate high signal foci on T1WI | ||||
Peripheral rim by fibrous tissue on T2WI | ||||
Strong enhancement on contrast enhanced-T1WI | ||||
Small cysts on T2WI | ||||
EAOC | Emergence of enhanced mural nodules within the ovarian endometrioma | [7,57,58] | ||
Increased tumor size (> 9 cm) | ||||
(suggestive) Dissapearance of shading on T2WI | [59] | |||
DIE | Hypointense nodular lesions (T1/T2WI) | [5,60,61,62] | ||
Soft tissue thickening with irregular, indistinct, or stellate margins (T1/T2WI) | ||||
Posterior cul-de-sac obliteration (pouch of Douglas, rectouterine/ retrovaginal space) | Retroflexed uterus | [69] | ||
Elevated posterior vaginal fornix on T1/T2WI | ||||
Intestinal tethering or tethered appearance of rectum in the direction of the uterus on T2WI | [69] | |||
Faint strands between the uterus and intestine on T2WI | [69] | |||
Fibrotic plaques or nodules covering the serosal surface of the uterus on T2WI | [69,70] | |||
Retrouterine fibrous mass on T2WI | [69,70] | |||
Intraperitoneal fluid displacement | [70] | |||
Torus uterinus, USL | T2-low intensity thickening or mass with regular or irregular margins on MRI | [63] | ||
Ovary | Kissing ovary | Bilateral ovaries are located in the posterior cul-de-sac or at the cornua of the uterus on MRI | [75] | |
Round ligament | Thickened and irregular with a nodular appearance on MRI | [77] | ||
Rectosigmoid colon | ‘Fan shaped’/‘mushroom cap’ | Focal thickening of the rectal wall as an umbrella-like head of a mushroom on MRI | [64,81] | |
Bladder endometriosis and vesicouterine space | Hypointense nodular formation on T1/T2WI | [60,85] | ||
Extra-pelvic endomtriosis | Abdominal wall endometriosis | On CT, homogeneous density | [93] | |
Gorgon’ sign | Linear infiltration irradiating peripherally from a central soft tissue nodule on CT | [93] | ||
On MRI, hypointense solid mass on T2WI with/without hyperintense hemorrhagic cysts on T1WI | [97] | |||
Diaphragmatic endometriosis | Hyperintense nodule on T1WI, mostly right side | [100] |
DIE = deeply infiltrating endometriosis, EAOC = endometriosis associated ovarian carcinoma, SI = signal intensity, T1WI = T1-weighted image, T2WI = T2-weighted image, US = ultrasonography, USL = uterosacral ligament