{"paper_id":"2ec7c1ee-777b-4c1b-a4a8-f587d4863cb8","body_text":"Abstract\nTransvaginal ultrasound (TVS) is considered the primary not invasive choice in patient assessment with suspected deep endometriosis (DE). The overall diagnostic performance of ultrasound for DIE lesions in rectosigmoid localization is good with high sensitivity and high specificity, and it was significantly higher than the overall diagnostic performance of TVS for assessing DIE in USLs, RVS, vaginal wall, and bladder. Comparing the diagnostic performance of TVS and MRI, we observed that it is similar. In 2016, the IDEA (International Deep Endometriosis Analysis) group consisting of some expert gynecological sonographers, surgeons, and radiologists have introduced a systematic sonographic approach about the assessment in women with clinical suspicion of deep endometriosis. The purpose of IDEA consensus was the standardization of terminology, definition of anatomic localizations, and measurement lesions modality. The IDEA approach counts of four systematic steps. The first step provides a routine assessment of uterus and adnexa; the principal aim is to detect adenomyosis and/or endometriomas. The second step is related the TVS “soft markers” (site specific tenderness and ovarian mobility). Third step provides the sliding sign used to assess the pouch of Douglas. The fourth step provides a systematic evaluation of the anterior and posterior compartment for the detection of endometriosis nodules. For vaginally located DE, the use of tenderness-guided ultrasound examination is recommended. In this modality, an increased amount of ultrasound gel is inserted into the transvaginal probe cover. This “standoff” technique creates a gap between the tip of the transvaginal probe and surrounding vaginal fornices. The sonovaginography is a sonographic transvaginal examination that allows a completion of the standard transvaginal ultrasound. 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Springer, Cham. https://doi.org/10.1007/978-3-030-97236-3_9\nDownload citation\nDOI: https://doi.org/10.1007/978-3-030-97236-3_9\nPublished:\nPublisher Name: Springer, Cham\nPrint ISBN: 978-3-030-97235-6\nOnline ISBN: 978-3-030-97236-3\neBook Packages: MedicineMedicine (R0)","source_license":"CC0","license_restricted":false}