Rectosigmoid endometriosis with unusual presentation at magnetic resonance imaging

We report on a patient with a bowel endometriotic nodule that was hypointense on both T1- and T2-weighted magnetic resonance imaging (MRI); histologic examination revealed that the MRI appearance of the nodule was due to the presence of extensive fibrosis. Bowel endometriotic nodules with extensive fibrosis and limited endometrial tissue have a signal intensity similar to that of the muscle on both T1- and T2-weighted images. In these patients, additional techniques such as multislice computed tomography enteroclysis may be used for adequate diagnosis before surgery. © 2009 American Society for Reproductive Medicine.