Deep Infiltrating Endometriosis A Pictorial Essay

Deep infiltrating endometriosis (DIE) is a subperitoneal intrusion of endometrial tissue. Resulting endometrial nodules may develop on the uterosacral ligament, urinary tract, rectovaginal, and retrocervical areas, and less commonly in the urinary bladder, thoracic, and neural regions. Genetics, age, and environmental factors determine the progression of the disease. DIE manifests with numerous symptoms, which are similar to unrelated diseases, namely dysmenorrhea, dyspareunia, urinary tract infections, and infertility. Transvaginal ultrasound, magnetic resonance imaging, computed tomography, and physical examination may detect and differentiate endometriosis lesions from other diseases. Its clinical management typically involves laparoscopic surgery and hormonal therapy. These are designed to improve the quality of life and to address individual reproductive goals. This pictorial essay aims to provide clinical cases to highlight the characteristic radiological findings in each diagnostic modality and in addition to elucidate the current clinical management of DIE.

Automated summary

Deep infiltrating endometriosis (DIE) is a condition where endometrial tissue infiltrates the uterosacral ligament, urinary tract, rectovaginal, and retrocervical areas. It can also rarely occur in the urinary bladder, thoracic, and neural regions. Symptoms of DIE include dysmenorrhea, dyspareunia, urinary tract infections, and infertility, which overlap with other unrelated diseases. Various diagnostic modalities, such as transvaginal ultrasound and magnetic resonance imaging, can help detect and differentiate endometriosis lesions from other diseases. Clinical management typically involves laparoscopic surgery and hormonal therapy to improve quality of life and address reproductive goals.