P27.02: The potential of three-dimensional (3D) ultrasound for the detection of deep endometriosis

The purpose of this presentation is to investigate the potential role of three-dimensional ultrasound (3D) in the assessment of deep endometriosis. Cases of deep endometriosis are presented to illustrate the spectrum of sonographic appearances obtained using 3D. In addition, we evaluate the possible role of other functions included in a 3D equipment such as niche mode and tomographic ultrasound imaging (TUI). The 3D image rendering could allow a good analysis of the endometriotic nodule, in fact in all presented cases, this reconstruction seems to make evident the irregular shapes and borders of the lesions. This technique allows an unrestricted access to an infinite number of viewing planes that can be very useful to correctly locate the lesions within the pelvis, evaluating the relationship with other organs. The stored 3D volumes can be reassessed and compared by the same or different examiners over time. This characteristic may be relevant for monitoring the effect of medical therapies over a period of time. Using niche mode, ultrasonographic imaging is represented as a “cut-open” view of the internal aspect of the nodule and its surrounding tissue. The TUI could be particularly useful for the evaluation of the extension of the nodule in the rectovaginal septum, depth of infiltration and the relationship with recto-sigmoid junction or the ureter. 3D in deep infiltrating endometriosis could be in a near future an interesting field of research with a positive effect in the every day clinical practice. This study was partially supported by Fondazione Banco di Sardegna