Fig. 20
From: Endometriosis: clinical features, MR imaging findings and pathologic correlation
Endometriosis of the anterior rectal wall in a 48-year-old woman with dysmenorrhea, chronic pelvic pain and catamenial diarrhoea. (a) Sagittal and (b) oblique coronal T2-weighted images, and (c) sagittal and (d) oblique coronal contrast-enhanced fat-suppressed T1-weighted images show an endometriotic nodule (white arrows) infiltrating the muscular layer of the anterior rectal wall. The lesion has a “fan shaped” configuration with the base adhering to the rectal wall and the apex oriented toward the retrocervical region. The implant demonstrates isointense signal compared to muscle on T2-weighted and T1-weighted sequences; the slightly high signal at the luminal side (white arrowheads in a and b) corresponds to (sub)mucosal thickening and enhances after intravenous administration of contrast material (white arrowheads in c and d). (e) Photomicrograph (H&E 40X). Endometriosis in the muscularis propria (black arrows)