OP35.08: 3D-sonographic relationships in patients with endometriosis associated with chronic pelvic pain

The detecting of endometriosis associated with chronic pelvic pain is an urgent problem. But modern sonographic algorithms are not fully developed for this group of patients. The aim of this study was assessment of efficiency of 3D transvaginal sonography (3D -TVS) in diagnosis of adenomyosis and external genital endometriosis in patients with chronic pelvic pain. 86 female patients (mean age 39,4 years) were included. 3D -TVS was performed with VOLUSON-730 Expert, 730-pro unit, using a wide-band 3,0–9,0 mhz transducer. Multiplanar mode, volume rendering, surface reconstruction mode, TUI, VCI, and “glass body” modes were used. The following additional diagnostic capabilities of 3D-TVS in patients with adenomiosis were determined (n = 59): 1) non-invasive detection of typical for adenomiosis changes of contour and shape of uterine cavity, comparable with hysterosalpingography; 2) accentuated “honeycomb” structure of miometrium in adenomiosis, detectable in surface reconstruction mode and VCI; 3) changed and/or depleted vascular pattern in lesions of endometriosis detectable in “glass body” mode; 4) high informativity in differential diagnosis of nodular adenomiosis. In diagnosis of deep infiltrating endometriosis (n = 11) and evaluation of it's invasion the VCI analysis by 2 mm slices of the stored 3D multiplanar examinations was very informative. In 16 cases of endometrial ovarial cysts in surface reconstruction, volume rendering and “glass body” modes the typical structure of content was clearly detectable (“frosted glass”-effect). In combination of endometriosis and adhesive process (n = 19) coronal view gives additive possibilities for differential diagnosis as deep endometriosis, as endometrial cysts with sactosalpinx. 3D -TVS improves accuracy of clinical diagnosis and evaluation of invasion extent of external forms of endometriosis, differential diagnosis of nodular forms of adenomiosis, endometrial ovarial cysts.