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CLINICAL AND IMAGING CHARACTERISTICS OF ABDOMINAL WALL ENDOMETRIOSIS IN PATIENTS TREATED WITH RADIOFREQUENCY ABLATION AT HANOI MEDICAL UNIVERSITY HOSPITAL
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Abstract
Objective: This study describes the clinical and imaging characteristics of patients with abdominal wall endometriosis (AWE) treated with radiofrequency ablation (RFA) at Hanoi Medical University Hospital. Subjects and Methods: A retrospective study was conducted on 17 patients with 28 AWE lesions treated with ultrasound-guided RFA from November 2023 to March 2025. Patients were diagnosed based on clinical evaluation, imaging, or pathological confirmation through lesion biopsy. Results: The mean patient age was 35.53 ± 4.99 years. The main clinical symptoms were palpable mass (88.2%) and cyclic abdominal pain (76.5%). All patients had a history of cesarean section. The mean latency period from the last cesarean section to symptom onset was 2.69 ± 2.25 years. Ultrasound features: All lesions were hypoechoic and heterogeneous (100%), with poorly defined margins (84.6%), solid appearance (73.1%), and vascular signals on Doppler ultrasound (41.2%). Lesion locations included the abdominal wall muscle (23.1%), subcutaneous fat (30.8%), and both subcutaneous fat and abdominal wall muscle (46.1%). MRI features: The lesions showed high signal intensity on T1-weighted images (T1W) compared to muscle (33.3%), isointense signal on T1W (40.7%), high signal intensity on T2-weighted images (T2W) (51.9%), mixed signal on T2W (40.7%), high signal on T1-fat saturation (T1FS) (74.1%), diffusion restriction on DWI/ADC (25.9%), and strong post-contrast enhancement (92.6%). Additionally, 11.8% of patients had ovarian endometriotic cysts. Conclusion: Abdominal wall endometriosis commonly occurs in reproductive-age women with a history of cesarean section. Cyclic abdominal pain and a palpable mass are suggestive clinical signs. Ultrasound and MRI help determine lesion characteristics, quantity, anatomical relationships, and contrast enhancement patterns, aiding in diagnosis and treatment planning.
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Keywords
abdominal wall endometriosis, ultrasound, magnetic resonance imaging
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