VP62.07: Role of widespread ultrasound in the diagnosis of ovarian and tubal endometriosis

To determine the role of ultrasound made by not expert sonographers in the diagnosis of tubo-ovarian endometriosis in surgical specimen. Retrospective analysis of surgical interventions, anatomopathological specimen and ultrasound diagnosis in women diagnosed of tubo-ovarian endometriosis during the last 3 years (2017–2019). During the study period we performed 450 tubo-ovarian surgical procedures (cystectomies, oophorectomies or adnexectomies), 100 of them were related to ovarian endometriosis (22.22%). Mean age of women was 39.6 years (range 17-56), 45% of them without previous pregnancies. The main complaint was pain (N:40, 40.0%), infertility (N:6, 6%), or the ultrasound detection of an ovarian mass (N:40, 40.0%). In the anatomopathological study, 89 patients had ovarian endometriosis (right ovary: N:28; left ovary: N: 40) and 21 women had bilateral endometriosis. 38 of the 94 fallopian tubes studied (40.4%) were affected: 21 were endometriosic (22.3%); acute (N:5) and chronic inflammation (N: 9), torsion (N:1) and hydrosalpinx (N:2) were also found. Ultrasound diagnosis of endometrioid lesions made by general gynecological sonographers was accurate in 64 cases (64.0%), all of them presenting typical ultrasound features of endometriomas. Confounding diagnosis were ovarian teratoma (N:17), simple cyst (N: 5); complex cyst (N:1); mucinous cystoadenoma (N:3) and ovarian fibroid (N:2). Mean size of endometriomas was 4.4 cm (range 1-14 cm). Only 7 cases (18.4%) of fallopian tube involvement were detected in ultrasound. Complications were diagnosed with the combination of ultrasound and clinical features, i.e ovarian torsion (N: 4), inflammatory pelvic disease (N: 2), or rupture of endometrioma (N:2). Endometriosis is not always an easy ultrasound diagnose as it can simulate other ovarian masses. Bilateral ovarian endometriosis must be discarded. Fallopian tube involvement should be investigated in the ultrasound scan. Complicated endometrioid lesions can be diagnosed with the help of ultrasound.