**5.1 Superficial implants**

442 Endometriosis - Basic Concepts and Current Research Trends

Fig. 4. Axial T2Weighted image showing the lesions are hypointense on T2W images.

bowel implants and ureteral obstruction can often be detected on MRI.

to identify superficial peritoneal implants on MRI.

phased array coils.

The solid nodules of DIE appear as low intermediate signal on T1 weighted with punctuate areas of high signal and uniform low signals on T2 weighted images. The high signal zone is the consequence of foci of haemorrhage bounded by fibrous tissues. However it is difficult

Adhesions in the pelvis are one of the hallmarks of the disease. They appear as low signal areas of stranding. Adhesions are also suggested by the fixed retroverted uterus, angulated loops of bowel or displacement of the ovaries. Complications of endometriosis such as

It is now feasible to see the visceral deposits on MRI directly. Rather some studies claim MR imaging to be more specific than endorectal USG with sensitivity and specificity of 90-92% and 91 to 98% respectively (Gougoutas CA et al). MRI has valuable role in identification of nerve invasion (sciatic endometriosis) and abdominal wall lesions. The accuracy of MRI has been improved with the introduction of newer approach particularly endocavitary and

M

Both USG and MRI has major limitation in diagnosing this type of endometriosis as already discussed. Endoscopy remains the standard practice to determine the extent of involvement by such lesions.
